Ask the Pharmacist Archive
- Can someone with diabetes take glutamine?
- Are severe leg cramps a condition of diabetes and, if so, what can be done to relieve or stop them?
- Can I take Advil® or Aleve® for a headache with type 1 diabetes?
- Can type 2 diabetes be treated with the combination of oral medications and insulin?
- If you are only taking metformin can your blood glucose drop too low? I thought I heard metformin does not cause hypoglycemia.
- I take 2000mg of metformin daily and my doctor wants to add glipizide. I am allergic to sulfa drugs. I'm worried about using glipizide because I've read people who are allergic to sulfa drugs shouldn't take glipizide. How serious is this warning and can I take glipizide or not?
- Are there different strengths of insulin available in FlexPen®?
- I suffer from seasonal allergies and have historically taken a combination of Nasonex® combined with Claritin-D®. I have been on metformin for the past year as I was diagnosed with type 2 diabetes. I have heard that people with diabetes need to be careful with allergy medicine. Can you recommend any allergy medicine that is relatively safe to take?
- Is there a product that will allow a blind person with diabetes draw up their insulin so they can either hear or know exactly how much insulin they are drawing up?
- I've been taken the drug Victoza® since 2006. What exactly is it and what does it do for your diabetes?
- Is it healthy to take insulin and pills for type 2 diabetes?
- How often should a person get an A1C test done?
- Are there any sources that will provide free syringes and stick pens?
- What is the highest dosage of metformin for type 2 diabetes?
- Is there a list of medications that can cause increases in blood glucose levels?
Can someone with diabetes take glutamine?
Unlike pharmaceuticals, "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 package labeling, prohibiting a product from making claims that it is intended to diagnose, treat, cure, or prevent a disease. We could not locate any information regarding the use of this product in someone with diabetes; therefore, we do not recommend its use without the consent of a physician.
Are severe leg cramps a condition of diabetes and, if so, what can be done to relieve or stop them?
There are many factors that can cause leg cramps such as medications, muscle tightness, loss of potassium and restless leg syndrome. We would suggest informing your physician about this issue so that he/she can determine the cause and come up with a proper treatment plan.
Can I take Advil® or Aleve® for a headache with type 1 diabetes?
Advil (ibuprofen) or Aleve (naproxen), when taken in the amount recommended on the over-the-counter (OTC) package, should not pose a problem in patients with diabetes. However, rare reports of both hyperglycemia and hypoglycemia have been noted with both products. If you are using these medications, we recommend that you monitor your blood glucose levels closely and notify your physician of any significant changes. In addition, check with your physician or pharmacist to make sure there are no drug interactions with your current prescription therapy and the OTC medication.
Can type 2 diabetes be treated with the combination of oral medications and insulin?
Yes, in fact, many people with type 2 diabetes need to try more than one type of treatment plan before they discover what works best for them. This treatment could include a single oral medication, a combination of oral medications, or oral medications plus insulin.
If you are only taking metformin can your blood glucose drop too low? I thought I heard metformin does not cause hypoglycemia.
The risk of developing hypoglycemia with metformin is much less than with some other diabetes medications (i.e. sulfonylureas), but is possible. Hypoglycemia caused by metformin is usually mild and does not require discontinuation of the medication; it is more common when metformin is co-administered with other medications for diabetes.
How often should a person get an A1C test done?
The glycosylated hemoglobin (HbA1C or A1C) test measures the average blood glucose over the past 2-3 months. The American Diabetes Association recommends an A1C test be performed at least two times a year in patients with stable glucose levels who are meeting treatment goals. In people who are not meeting their glucose goals or have had a change in therapy, the A1C test should be performed quarterly.
I've been taken the drug Victoza® since 2006. What exactly is it and what does it do for your diabetes?
Victoza (liraglutide) is similar to a hormone made naturally in the body called GLP-1 (glucagon-like peptide-1). When glucose levels are high after a meal, GLP-1 is released from the small intestine and stimulates the pancreas to release insulin. It also helps decrease the amount of sugar made by the liver. If your body does not make enough GLP-1 or isn’t using it correctly, you may not be getting the right amount of insulin needed to move glucose from the blood into the cells. Victoza acts like GLP-1 and may improve blood sugar in adult patients with type 2 diabetes when used along with diet and exercise. It is not recommended as the first medication to treat diabetes and is not for people with type 1 diabetes or people with diabetic ketoacidosis (accumulation of ketones in the blood and urine). For more information visit www.victoza.com.
Is there a product that will allow a blind person with diabetes draw up their insulin so they can either hear or know exactly how much insulin they are drawing up?
Drawing up insulin can be especially challenging for blind or visually impaired patients. There are products available that can help. The Prodigy Count-a-Dose device draws up one unit of insulin at a time and makes a “click” sound with each increment. It can hold one or two bottles of insulin for easy mixing. For more information visit http://prodigymeter.com/?page_id=123. The Safe Shot Syringe Loader, by Borin-Halbich, can be adjusted to a particular dosage to allow you to draw up the same amount of insulin every time. It is appropriate for people on fixed dose regimens. For more information on aids for insulin users, go to http://forecast.diabetes.org/files/images/v66n01_p62-65_0.pdf
Is there a list of medications that can cause increases in blood glucose levels?
There are many medications that may cause increases in blood glucose levels. Some examples include corticosteroids, select antipsychotics, certain water pills and blood pressure medications. If you would like a pharmacist to review your list of medications to determine if any can cause an increase in blood glucose, visit https://www.riteaid.com/pharmacy/chat-with-a-pharmacist to chat live with a Rite Aid pharmacist, or you may submit a question with a list of your medications through our secure message center at https://cms.riteaid.com.
I take 2000mg of metformin daily and my doctor wants to add glipizide. I am allergic to sulfa drugs. I'm worried about using glipizide because I've read people who are allergic to sulfa drugs shouldn't take glipizide. How serious is this warning and can I take glipizide or not?
Glipizide is in a class of drugs called the sulfonylureas. Its structure is similar to that of the sulfa antibiotics. The use of glipizide is not contraindicated for people who are allergic to sulfa antibiotics, but caution should be exercised because an allergic reaction is possible. If you decide to try glipizide, your physician should monitor you closely. Be sure to report any symptoms of an allergic reaction to your doctor. Get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness and/or trouble breathing.
Are there different strengths of insulin available in FlexPen®?
The FlexPen is a prefilled, dial-a-dose insulin pen by Novo Nordisk. There are 3 different types of insulin available in FlexPen:
• Levemir® (insulin detemir) injection – a long acting insulin
• NovoLog® (insulin aspart) injection – a rapid acting insulin
• NovoLog® Mix 70/30 (70% insulin aspart protamine suspension and 30% insulin aspart) injection – a combination of rapid and longer acting insulin
I suffer from seasonal allergies and have historically taken a combination of Nasonex® combined with Claritin-D®. I have been on metformin for the past year as I was diagnosed with type 2 diabetes. I have heard that people with diabetes need to be careful with allergy medicine. Can you recommend any allergy medicine that is relatively safe to take?
Nasal corticosteroids, like Nasonex, can be used to treat allergy symptoms such as congestion, sneezing, and itchy/runny nose, and are not expected to affect blood glucose levels. Antihistamines can temporarily relieve runny nose, sneezing and itching, and do not interfere with diabetes control. Decongestants help to relieve sinus congestion and pressure, but can interfere with diabetes control. Claritin-D contains loratadine (an antihistamine) and pseudoephedrine (a decongestant) and may cause changes in your blood glucose levels. A better option would be an antihistamine-only product such as Claritin® (loratadine). Other antihistamines available over the counter include diphenhydramine, chlorpheniramine, doxylamine, clemastine, cetirizine, and fexofenadine. Alternatives to decongestants include saline nasal spray and nasal strips. Saline nasal spray may be used to help break up and clear nasal congestion. Nasal strips are drug-free devices applied to the outside of the nose to gently open the nasal passages and improve airflow through the nose and relieve nasal congestion.
Are there any sources that will provide free syringes and stick pens?
Many manufacturers offer discounted or free products to eligible patients in need. Simply contact the manufacturer of your syringes to determine if a patient assistance program is available. The following are examples of some companies with syringe assistance programs: Becton Dickinson (1-866-818-6906) and Allison Medical (1-800-886-1618).
What is the highest dosage of metformin for type 2 diabetes?
Metformin is available in regular and extended release formulations. The maximum dosage limits for an adult are 2,550 mg/day for regular-release metformin tablets and oral solution; 2,000 mg/day for all extended-release tablets except Fortamet®, which has a maximum daily dose of 2,500 mg/day. Please remember, you should never adjust your dosage without the advice/consent of your physician.
Is it healthy to take insulin and pills for type 2 diabetes?
It is not uncommon for a person with type 2 diabetes to be treated with more than one medication. When a person is first diagnosed with type 2 diabetes, lifestyle modification (e.g. healthy diet, weight loss, exercise) along with metformin (an oral medication) are generally prescribed. If glucose goals are not met after approximately 3 months, a second medication is usually added. This could be an oral diabetes medication, an injectable (non-insulin) diabetes medication, or insulin. If after 3 months the treatment goals are still not achieved, a third agent may be added.
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