Optimal diabetes care typically involves frequent adjustments to your regimen for blood glucose, blood pressure, and blood cholesterol control. If your doctor has not adjusted your medicines or doses recently, ask him to review your medicines with a view to keeping you in good control.
As many tried-and-true medicines go generic, updating your drugs may save you money. Review them with your doctor or pharmacist with a view to lowering costs, and consider using combination tablets that contain more than one drug to reduce your co-pays and the number of pills you take each day. Often, it is both cheaper and safer to use older, proven medicines than to use brand-new ones.
Avoiding insulin errors
Nearly 5 million Americans with diabetes use insulin, which has saved or extended the lives of many more millions of people since it was discovered in 1922. The newer insulins offer a degree of flexibility and control that is greater than that of any other blood-glucose-lowering medicine. Yet there are some substantial risks associated with insulin use and some errors that need to be carefully avoided.
Many people who take insulin use more than one type (usually a long-acting insulin and a rapid-acting one), and it’s possible to confuse the two types of insulin and take the wrong one at the wrong time. There are a number of ways to avoid such a mix-up:
- Keep your rapid-acting and long-acting insulins in consistent and different locations.
- Mark your vials or pens in some way so it’s clear which is which.
- Note whether one of your insulins is cloudy and one clear. (This won’t be the case for everyone, but for some people it may be true.)
- Note whether the vials or pens for both types of insulin are the same or different shapes and sizes.
- Use a pen for one type of insulin and syringes and a vial for the other.
- Some people learn to adjust their mealtime doses of rapid-acting insulin based on their blood glucose level before the meal, the number of grams or servings of carbohydrate in the coming meal, and sometimes on any planned exercise. To make sure you are adjusting your doses correctly, be sure to perform regular blood glucose monitoring and to discuss your readings with your diabetes care team.
- Some other common mistakes are to skip a dose of long-acting insulin at bedtime because of a lower-than-normal reading (a decision that may cause blood glucose levels to run high all of the next day), to not take insulin when ill (also a decision that may result in high blood glucose), to draw up the wrong dose, to use a vial of insulin or pen beyond the number of days recommended by the manufacturer, and to expose insulin to temperature extremes, rendering it ineffective.
- Have a sick-day plan that you have discussed with your doctor and diabetes educator. It should specify how to maintain blood glucose control while you are ill and also when to call your health-care provider for advice.
- Read the information that comes with your insulin and be sure you are storing it correctly and are aware of the number of days an opened vial or pen can be used.
Have you ever had a blood glucose reading of less than 70 mg/dl on your meter? If so, you have experienced the level of blood glucose at which most people are advised to treat for hypoglycemia. How did you feel? What did you do? It is common to occasionally have readings below 70 mg/dl if you are taking good care of your diabetes. Such low blood glucose levels are usually not a threat to your well-being — as long as you recognize the low blood glucose level and respond to it promptly and appropriately.