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Updated September 06, 2012

Managing Hyperglycemia

by Laura Hieronymus, MSEd, APRN, BC-ADM, CDE, and Belinda O'Connell, MS, RD, CDE

Has the medicine expired? Check the expiration date on your medicine to see if it is still good. Most pills have a long shelf life, but insulin does not. In addition, the expiration date on the insulin packaging is for unopened, refrigerated vials, disposable pens, or pen cartridges. Once opened, most vials of insulin last for 28 days, but many pens and pen cartridges are good for only 7, 10, or 14 days. Pump users should change their infusion set and the insulin in the pump reservoir every two to three days. These limits should be noted in the insulin package insert. If you’re not sure how long your opened container of insulin will last, ask a member of your diabetes care team or your pharmacist or call the manufacturer’s customer service number.

Is your technique for taking your medicine adequate? If you take pills, be sure you’re taking them at the right time of day. Some pills must be taken right before meals to work effectively; others do not. If you take insulin by pen or syringe, review your injection technique with your diabetes care team. You should be aware that if you switch to a different syringe or insulin pen or from one to the other, the injection technique may differ.

Are you storing your medicine properly? Insulin, as well as oral medicines, can lose potency if exposed to heat, cold, or moisture. Your best bet is usually to store opened containers of medicines you are currently using at room temperature. Unopened pills can also be stored at room temperature. Insulin that has not been opened should be stored in the refrigerator. Be careful not to place insulin in the particularly cold areas of the refrigerator — typically the meat compartment and at the backs of the main shelves — where it may freeze.

Is your insulin being delivered adequately? If you use an insulin syringe or insulin pen, do you always use the same size needle? Some people find that a change in the needle length can disrupt their control. If you use an insulin pump, review the set-up of your infusion set with your diabetes care team to assure accurate insulin delivery. If you order pump supplies by mail, double-check your order when it arrives to make sure you received the correct supplies. Using a different size catheter or a different tubing length than usual may change the amount of priming necessary. (All pump users should have alternative methods of insulin delivery on hand should their pump malfunction or stop delivering insulin for any reason.) In addition, check your injection or infusion sites periodically. If toughening or scarring of the skin is present, this may affect absorption of your insulin.

If you use an insulin pump, is the battery power sufficient? Avoid going to sleep at night or becoming preoccupied with other things when your battery is low. Be attentive to low battery warning alarms, and change your batteries promptly when they sound. Don’t wait until you’ve used the last drop of energy in your battery.

Are you taking any other medicines that could affect your blood glucose level? Certain types of drugs — including prescription drugs, over-the-counter drugs, and herbal preparations — may contribute to hyperglycemia. Common prescription drugs that have a tendency to increase blood glucose levels include corticosteroids (used to treat inflammation) and thiazide diuretics (used to treat high blood pressure).

Any time you receive a prescription for a new drug, whether for a diabetes-related condition or not, ask your doctor if it may have any effects on your blood glucose levels. In addition, tell your health-care team about any over-the-counter medicines or alternative therapies you use so that together you can determine whether those substances or practices are having an effect on your blood glucose control.

Also in this article:
Blood Glucose Targets

Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

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1. Insulin
2. Blood Glucose Monitoring
3. High Blood Glucose
4. Nutrition & Meal Planning
5. Diabetic Complications