Diabetes Self-Management Articles

These articles cover a wide range of subjects, from the most basic aspects of diabetes care to the nitty-gritty specifics.

Links not loading properly?

Some of our pages use Portable Document Format (PDF) files, which require Adobe Acrobat Reader. To download Acrobat Reader for free, visit www.adobe.com.

Sign up for our weekly e-mail newsletter and receive a FREE GIFT! Enter your e-mail below.

Learn more

Learn more about diabetes

Links to help you learn more about diabetes.

Ask a diabetes expert
Other diabetes resources
Browse article topics

 

Exenatide and Pramlintide
New Meds on the Block

by Stacy Griffin, Pharm.D., and John Borders, M.D.

Tips for use. Your response to exenatide and to all other diabetes medicines will be better if you eat well-balanced meals, watch portion sizes, and stay physically active.

You will need to continue to monitor your blood glucose levels when taking exenatide. Varying the times at which you monitor, and monitoring both before meals and after meals on some days may be useful to evaluate any changes in blood glucose control. Work with your diabetes care team to determine a monitoring schedule that is right for you.

Pramlintide

A healthy pancreas releases both insulin and amylin in response to food intake. However, people with Type 1 diabetes and many with Type 2 diabetes do not make enough insulin, with the result being that glucose from food stays in the bloodstream rather than entering muscle, fat, and other body cells. In general, people who do not produce enough insulin also do not make enough amylin at mealtimes. Without enough amylin, glucose from food enters the bloodstream more quickly than normal, causing blood glucose levels to rise.

Pramlintide, a synthetic analog of human amylin, helps to reduce the rise in blood glucose after meals in the following ways:

  • It slows the speed with which food leaves the stomach.
  • It suppresses the secretion of glucagon after meals, which decreases the amount of glucose released from the liver.
  • It decreases appetite, so that less food is eaten. This can also lead to a small weight loss in some people.

Pramlintide is approved for use in adults with Type 1 diabetes and adults with Type 2 diabetes who have not achieved adequate blood glucose control when using intensive insulin therapy.

How to take pramlintide. Like exenatide, pramlintide must be injected, but unlike exenatide, it is not yet available in a pen device. (The SymlinPen 60 and SymlinPen 120, pen-injector devices that can delivered fixed doses of pramlintide, and are expected to be available by December 2007.) Currently, a standard, U-100 insulin syringe is used to administer pramlintide. However, pramlintide is dosed in micrograms (µg), while insulin is dosed in units. To see how micrograms correspond with units, check out the table “Pramlintide: Drawing Up the Right Dose.” Your health-care provider will tell you what size doses to take and should also demonstrate how to measure doses and inject them. Pramlintide should not be mixed with insulin or any other injectable drug in the same syringe.

Pramlintide should be injected just under the skin of the stomach area or upper thigh more than 2 inches away from insulin injections given at the same time. Pramlintide should be at room temperature when injected. A new, unused syringe and needle should be used for each pramlintide injection and then discarded in a sharps container.

Pramlintide is to be taken just before any meal that contains at least 250 calories or 30 grams of carbohydrate. Peak action is reached in approximately 20 minutes and diminishes over three hours. Unlike insulin, doses of pramlintide do not need to be adjusted for the amount of carbohydrate in meals or for physical activity. However, if you skip a meal, the dose of pramlintide should also be skipped.

Generally, pramlintide is started at very low doses, and the doses are increased gradually depending on how well it is tolerated. When you first start taking pramlintide, your physician may decrease your mealtime insulin doses to account for the effects of pramlintide and to decrease your chances of developing low blood glucose. Your physician should direct any changes to your doses of insulin and/or pramlintide as you find what works best for you.

Pramlintide vials should be stored in the refrigerator until opened. Opened vials can be refrigerated or kept at room temperature for up to 28 days. Using an insulated container that is kept cool is recommended when traveling. Do not freeze vials of pramlintide, and discard any that are accidentally frozen. Vials should be discarded 28 days after first use, even if there is some medicine left. Do not use a vial of pramlintide if it looks cloudy.

Page    1    2    3    4    5    Show All    

 

 

More articles on Oral Medicines
More articles on Insulin & Other Injected Drugs

 

 


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.

 

 

Keeping Skin Healthy With Diabetes
Good skin makes us attractive, maybe because it signifies health, and health is sexy. But diabetes... Blog

New to Diabetes: What's Next? (Part 1)
Back in October, I posted a piece called "Getting Started With Type 2 Diabetes." My intent... Blog

Hormone Hoopla: Movers and Shakers of Diabetes (Part 2)
Hormones are chemical messengers in the body, produced by the endocrine glands. The glands... Blog

For how long can I use a vial of insulin? Get tip


Blood Glucose Self-Monitoring — Part 1: The Gear
Blood glucose self-monitoring is one of the keys to diabetes control. Here are the tools you need to carry out this task.

Perfectionism: An Impossible Goal in Diabetes Management
Striving for good self-care is important, but perfectionism can make diabetes care — and life — more difficult.

Recipes for Spring
Enjoy recipes for Baked salmon on beet greens, Tofu and snow pea slaw, Radish and cucumber salad, Spinach pinwheels, Beet salad with citrus dressing, and Stuffed berries.

Complete table of contents
Get a FREE ISSUE
Subscription questions