Most diabetics cannot escape from the ultimate reality: buying diabetic products.

The first of these is a diabetic glucose meter. Whether your sugar levels are high or low, you will need to monitor your glucose levels closely. If you are new to the condition, you may want to test your blood sugar levels 2-3 times a day. As you exercise food control and start regular exercise, you may have a better awareness of how to keep your blood glucose levels stable. Even when you are acclimatized to your body’s fluctuating glucose levels, you might feel comfortable keeping a precise count of your blood sugar levels.

There are different models of blood glucose meters available. Blood glucose meters are portable and give readings in under a few seconds. For most beginners, the best model is one that requires just a small drop of blood to give precise readings.

Another important diabetic product is the test strip. Test strips, lancets, wipes and sanitizing lotion make up the complete diabetic test kit. Having all these products grouped together as a kit makes it easy for you to move around without worrying about one or the other product.

Different kinds of syringes are available to help patients administer insulin safely and painlessly. Syringes are designed to ensure maximum comfort without compromising accuracy.

In addition to these, patients may also have to use certain specialized diabetic products that can become a part of the emergency kit. Glucose pens, glucose tablets and insulin are a part of the kit. Many patients also prefer to carry a medic alert bracelet. This is worn over the hand and it alerts emergency personnel of your diabetic condition.

It is important to keep in mind that diabetic products are being reinvented all the time. New products offer even more convenience and accuracy than before. Therefore, it makes sense to keep up with changing products. Even if you are quite satisfied with a particular product, you may need to change the device from time to time, as these products tend to lose accuracy over time.

If you are a diabetic, you can help yourself by keeping a regular tab over what is new in the market and whether the product is of help to you. Your aim should be to strike a balance between your needs, your finances and your convenience.

Unfortunately in countries where paramedic support is poor, Insulin treatment becomes more difficult. Most doctors prescribe Insulin but they have no time to train patients about taking Insulin shots. Very often an untrained person trains patients or they have to figure it out for themselves.

And so Insulin prick-related problems are common in these countries. Problems like lipohypertrophy, injection site marks, infections are more common.

One of the most important aspects of Insulin injection technique is injection site. Insulin should reach subcutaneous tissue, that is, the layer of fat below skin. So areas like the abdomen, outer side of thigh and arms are considered as good sites. Unfortunately, many patients still inject it into the forearm or calf region, which is not correct.

Apart from site, the next important thing is angle of injection. Earlier, longer needles of 12 mm were available and hence it was recommended to inject at 45-degree angle so as to avoid intramuscularly injection, particularly in individuals with a thin built. But nowadays, shorter needles of 5 to 6 mm are available. With these needles, it is best to inject Insulin at 90-degree angle.

Injection site rotation is yet another important concept. If Insulin is injected at same point then that area of skin becomes more fatty and this is called lipohypertrophy. Insulin injected into this area is absorbed slowly and erratically and this makes sugar control difficult. Since the prick in this area is painless, the patient prefers it but later on gets in trouble due to fluctuations in glucose levels. Thus, it is very important that a patient should inject at different points and should go on rotating injection sites.

Another focus should be on the site of injection and rate of Insulin absorption. Most of the studies show that absorption is most rapid at abdomen. Hence it is important that morning Insulin or short acting Insulin can be injected into abdomen while night insulin can be injected into thigh. Alternatively, all morning shots can be taken on abdomen while evening shots on thigh so as to make insulin absorption more consistent. This would avoid unexpected variation in insulin level due to injection site change.

Though needles are made for a single use, most people are reusing needles due to cost factor. Ideally a patient should not reuse a needle, but still if one has to, then consider a few points. Better not to reuse a needle more than three or four times. Do not boil it. In fact, do not touch the needle. Maintain personal hygiene and wash hands before injecting insulin.

With repetitive use,  the needle’s tip becomes blunt and it can cause injury to skin and create a point for bacterial entry, leading to infection. Thus, as a rule of thumb, if a needle hurts, do not reuse it.

Safron Jeen asked:


1. Daily estimation of blood sugar levels

Daily estimation of blood sugar levels is necessary in all cases of diabetes – three times a day i.e. fasting, before lunch and dinner. However, at least twice daily measurement of blood sugar levels must be taken – fasting and before dinner. All diabetics are advised to use a blood glucose meter at home for a regular check-up of their blood sugar levels.

If a diabetic finds more/elevated sugar in his blood, he should analyse as follows:

(i) What has he been doing for the last 2 hours? He may be under stress.

(ii) Did he eat more?

(iii) Did he get less insulin/oral drug?

He should act as follows:

(i) If the result is mild sugar, do exercise, jump, walk; the sugar will thus get consumed or dissipated.

(ii) Avoid stress.

(iii) If the quantity of sugar is high, he should regulate his subsequent diet, exercise and drugs.

(iv) If the sugar is alarmingly high, he should consult his physician immediately.

2. Self-insulin injection

If the patient is on insulin injections, he should preferably learn the technique of self-injecting insulin into the various sites of his/her body. In such cases one should know about the proper sterilisation of syringes, needles, or preferably use disposabl~ syringes as well as needles which are available particularly for injecting insulin. A device such as NovoPen 3, like a pen loaded with penfill (refill containing enough insulin which can be used for many days depending on the need of the patient) can also be used for administering the daily dosages of insulin, under the direction of the physician. The penfill can be replaced when exhausted.

3. Prevent diabetic coma

A diabetic should avoid fasting. Even if a diabetic is get ting diarrhoea/vomiting/both, he should take the insulin/oral drug along with glucose/sugar dissolved in water as soon as the situation permits. In advanced cases, referral to a hospital is important for glucose therapy along with parenteral insulin. If the above is not strictly followed, it will lead to diabetic coma which is a medical emergency.

4. More about diabetic coma

It occurs when the blood sugar level becomes below normal (hypoglycaemic coma) or very high (hyperglycaemic coma). In the former case the patient say have taken more than the prescribed dosages of antidiabetic drugs in over-enthusiasm to make the blood sugar levels normal, or he may have taken meagre food with the same dosages of antidiabetic drugs. In the latter case, the patient either misses the drug, or takes heavy food as well; the chances are much more when there is some infection in the body.

The symptoms / signs of both the above types of coma are different. In hypoglycaemic coma, the skin is moist with profuse perspiration which can be noticed even by a person standing nearby. All diabetics should be aware of these symptoms and as soon as they start perspiring, they should start taking sugar cubes which every diabetic is required to keep in his pocket. In hyperglycaemic coma, the skin is dry. To meet this emergency efficiently, diabetics are required to keep a card in their pockets indicating that they are diabetic, so that on reaching the hospital, the doctor on duty can immediately ascertain the cause of coma and start treatment.



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Hector Milla asked:


The age factor is not a great matter with diabetic patients because diabetes affects all people, even children, in result injuring the heart, kidneys and even nerve systems if left untreated. Treatment for diabetes is necessary for diabetic patients in order to avoid other possible complications. Diabetes is an imbalanced of the sugar levels that affects different people of different ages where proper medication for diabetes patients is important in maintaining their glucose or sugar levels.

Diabetes is the most silent type of disease that can cause death and disability to people of different races all over the world. Significantly speaking, diabetic patients need proper care to help manage their condition to live a normal and satisfying life. As such, diabetic supplies for diabetic patients are acquirable in various medical stores worldwide. These supplies will allow diabetic patients help maintain their blood sugar and at the same time treat their condition.

A variation of supplies for diabetic patients is at hand. For example, self administered test kits for patients without the knowledge that they have diabetes can be bought to make test available to knowing if there are diabetic or not. These self-test kits include test strips and blood glucose meters that calculate glucose levels for individual patients. There are two kinds of meters that can be used to calculate the glucose level: one type is the meter that changes in color to show the glucose level and the other meter displays a digital reading for the glucose level.

Utilizing a self-test kit is easy and very convenient for any patient. Using a lancet or a piercing device with a built-in needle to get blood samples to perform the test can help patients distinguish if they are diabetic or not. These lancets are individual units that are not transposable from one patient to another, costing according to the types of brand ranges from $65 to $70 per unit.

Recommendation for buying blood glucose meters have several options because of the different kinds of features it offers. These features include a memory to help monitor sugar levels while other features a voice systems where a step-by-step procedure for glucose testing is included. Also, another feature includes the action test strip that eventually helps get blood on the strip itself.

There are different brand names available for these self-test kits like the accu-check, the one-touch ultra, the one-touch sure step and the freestyle test strips that will help you perform a test if you are a diabetic or not.

Other available supplies for diabetic patients are the different selections for an insulin delivery system. These insulin systems help assist diabetic patient in taking insulin or particular medications. These supplies vary according to the type of medication needed to treat patients with diabetes. The following supplies are: pen and jet injectors, insulin pumps and infusers, and the normal syringe are helpful in taking insulin doses.

Diabetes supplies is really important to people with diabetes, however, these supplies are also costly and can be quite expensive. Due to additional cases for diagnosed patients with diabetes, a surplus of diabetic supplies is needed. Even health care increase, estimating nearly to $100 billion a year, have become a problem, therefore, affecting people with the way diabetes have affected their lives. In a way, diabetic supplies are still helpful and gives diabetic patients an opportunity to lead normal and satisfying lives that is necessary for treatment.



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Dr. Ripudaman Singh asked:


Importance of sleep.

Right amount of rest is essential in taking control of our health and unfortunately it is often over looked. Sleep is something very important. It is great if one could go to bed and wake up with better blood sugar control?

In fact, that may be what you do when you get adequate sleep. Research suggests that not getting the shuteye you need may contribute to insulin resistance. One reason is that poor sleepers often experience sleep apnea, a condition that interferes with normal breathing and has been linked to diabetes.

There has been evidence that sleep by itself helps the body use glucose more efficiently.

One study found that people averaged roughly 5 hours of sleep had 40% lower insulin sensitivity than people who got about 8 hours.

Are you getting enough sleep?

Probably not: most people get 60 – 90 minutes less than they need.

If this sounds like a problem with a simple solution, it is. Spend more time in bed.

Getting enough sleep is as much about quality as quantity, and its not always easy to drift off when you want to, especially when your under stress.

Fortunately, if you are following my 3 step program, you’re already doing plenty that will help you get good sleep : eating right, exercising, and managing stress.

If you can however, try these tips.



1. Don’t sleep in. Snoozing later on week ends to try to catch up on sleep may throw your rhythm out and may be harder to get to sleep at night. If you are going to add sleep time, do it by going to bed earlier.

2. Reserve your bedroom for sleep – Take the TV OUT

3. Leave your worries on paper. If you are one of those who bring your worries to bed – try writing them down on paper with possible solutions. Often times if  you feel like you dealt with the situation it will help you drift off more quickly. A trick I use is even in the dark I reach for my paper and pen to jot down things I can’t get out of my mind.  When I have a clear mind I finally drift off.

4. Know when to go to bed. Figure out a schedule and try to stick with it the best that you can. Often times we loose track of time and get watching TV and before we know it is past midnight.

5. If you wake up in the middle of the night stay in bed, you will have a better chance of falling back to sleep.

 



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Molly Lyons asked:


Managing type 1 is a tall order for many kids. “The whole system hinges on adherence at every step: testing blood sugar, giving shots, recording every little thing they eat,” explains Naomi Neufeld, M.D., clinical professor of pediatrics at the University of California, Los Angeles. “But it doesn’t always happen, especially when your kids aren’t in your sight.”

The good news is that several innovations are making it easier for kids-and their parents or guardians-to keep careful control.

Monitors

Wireless blood-glucose meters using cell-phone or Bluetooth® technology store readings and can transmit them to a computer at home or at the doctor’s. The physician can view your child’s blood sugar history on a single screen, which makes it easier to spot trends and problems.

Talk to your doctor about the right device for your child. Some wireless monitors are not FDA-approved for kids, and your insurance may not cover them all. Some doctors also use the continuous glucose monitor with kids, even though it’s not FDA-approved for use with children. This device, which measures glucose levels in the tissue fluid under the skin, isn’t a substitute for the blood glucose monitor.

Insulin pumps

These wearable pumps for continuous administration of insulin can be a boon to kids. In one study from the Joslin Diabetes Center in Boston, school-age children on pumps monitored themselves more frequently, needed less insulin daily and had better blood sugar control than those using standard injection therapy. Studies have found that children as young as 18 months can use the portable pumps effectively. The pumps provide a baseline level of insulin throughout the day and can be programmed to give rapid-acting insulin analogues before or immediately after meals. Someone still has to enter the amount of insulin to administer, and that depends on what the child is eating.

Combination monitor-pumps

“These devices are the most promising to pediatric endocrinologists,” says Dr. Neufeld. The pumps sense glucose and automatically adjust insulin. The first model may be available this year.

New ways to deliver insulin

For toddlers, rapid-acting insulins are ideal. “At this age, you can’t always predict what they’re going to eat,” says Dr. Neufeld. (Inhaled insulin, which acts rapidly but lasts as long as regular insulin, is pending approval for use in children; its effect on developing lung tissue still needs to be determined.)

Endocrinologists are also investigating the treatment of other diseases in the hopes of finding applicable technologies. A new pen for injecting growth hormones, for example, records time and dose with an iPod-like device, says Dr. Neufeld, “and there’s no reason it couldn’t be used for diabetes.”

Be receptive to changes in technology, say experts, and ask your doctor to keep you up-to-date. The latest-and future-devices won’t take patient responsibility out of the equation, but they will make your life and your child’s life easier.

Source: Diabetes Care, November 2006.

Ask the Right Questions

Thinking of trying a new device? The American Diabetes Association advises asking your doctor:

* What experiences have other patients had with it?

* Have insurance companies covered the costs?

* Are there benefits to a pump over injections?

* What’s involved in going from injections to a pump?

* Is it clear how much insulin to use with a pump?

* If my child gets continuous insulin, how will it affect what she eats and how she exercises?

* What kind of training will my child and I receive?

* How often will blood sugars need to be checked?

* Does it hurt?

The latest crop of diabetic devices offer exciting possibilities for glucose control for children with type 1 diabetes-and adults, too. Find out which one is right your family.

Molly Lyons

©MDminute: Diabetes Issue 1, 2007



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Bill Urell asked:


Having diabetes does not mean that the world is ending. If you are having the urge to travel, then go ahead, do not let it keep you.

But then, you need to take care of your supplies first before going. Being careful is the best way to avoid accidents and emergency situations.

First thing to do it to prepare a check list of supplies you need to bring. This may include:

* Vials of insulin or * Insulin loaded syringes * Oral medication * Numerous syringes and/or pen needles * Lancet or other finger pricking devices * Glucose metes * Batteries for meter * Meter solutions * Glucose strips * Insulin pump * Supplies for your insulin pump like fresh batteries, plastic tubes, needles and cathethers * Glucagon kit for emergencies * Urine test strips * Alcohol swabs * A disposal container for your sharp instruments * ID and diabetes identity cards * Medical insurance cards * Emergency glucose (glucose tablets)

Place all of these in one bag for ease of use and for facilitation of screening at the airport. Pack twice as much as you need so you will not be short. You might also want to bring all your prescription so that in the case that your bag was lost, all items can be replaced promptly.

Next, you need to determine how to store your insulin. Insulin is stable at room temperature but it can lose its therapeutic effect if it is stored in a very hot or very cold place. The next time you go to your supplies store, try looking for travel packs for your insulin.

Then, you need to make sure that all your supplies are properly labeled. There is no limit to the number of syringes or lancets you can bring but they need to be properly stored and labeled. Used syringes and lancets should be in a sharps container and the container also labeled.

Ensure that your strips are placed in a waterproof container. If you have the foil wrapped strips, double wrap them in zip lock bags just to be careful.

Make sure that batteries for your meters are of the right kind and are brand new. Many people overlook this and end up bringing the wrong kind or used up batteries.

Also, take a sturdy plastic or paper back for your trash. This will hold your used alcohol swabs, strips and strip-wrappers.

When you get to the airport, alert security that you have diabetes and are carrying supplies. Show them your identification if needs be. If you are wearing an insulin pump, you need to tell the inspectors that the pump cannot be removed because it is connected to a catheter under your skin.

Unpack and repack your supplies yourself if security demands it. This will ensure that there is no contamination or loss of article.

You should not worry about the effect of the x-ray on your pump or meters. Most of them are designed to pass through the scanners safely. If you still have doubts, ask security for a visual inspection instead.

However, keep in mind that if you request for a visual inspection, there might be items that cannot be screened just visually. This may need x-ray scanning. If you refuse, you will not be allowed to have them onboard.

Traveling is a fun and joyful experience. You need not be hampered by disease to enjoy it fully. Just remember to take the proper precaution, be conscious of your body and pack your supplies properly.

Oh and have a great time!



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Adrian Adams asked:


Those who suffer with diabetes have to take the hormone insulin in order to control blood glucose or sugar. You cannot take insulin by way of mouth because it is destroyed by the digestive system before it is able to reach its mark. There are a few devices that deliver insulin to diabetics and it is usually up to the individual the type of delivery system they prefer.

Researchers are working hard every day so that those who suffer with diabetes in the future don’t have to use a needle to get the insulin they need. They are constantly testing new ways to introduce insulin into the blood stream of patients who require it.

Different Types of Delivery Devices

At present, the only way to effectively take insulin into the body is through the fatty tissue of the skin. It is not particularly painful, but for those who are queasy around needles, taking their daily dose of insulin can be something that is looked upon with much trepidation.

Using a Syringe

The most common device used to deliver a patient their insulin is with a syringe. Syringes used for insulin injection are small and sharp hypodermic needles. Most of the syringes come coated with a special substance to make injecting the needle into the skin less painful. Insulin syringes com in a variety of sizes and dosages.

The Insulin Pen

At first glance, you might mistake the insulin pen for a conventional cartridge ink pen. Instead of ink, these cartridges are filled with insulin. Many diabetics prefer this delivery method. The ease and convenience of an insulin pen is the attraction for most users. You can purchase an insulin pen that can be refilled, or you can choose a model that can be discarded after the cartridge is finished.

Dosing is easy as well. The tip of the pen resembles that of an insulin syringe. You simply turn the dial and select the proper dosage prescribed for you. You then press the plunger to deliver the dose of insulin under your skin.

Using the Jet Injector Method

As we mentioned, there are many people that are uncomfortable using needles. Those people have the option to use the jet injector to deliver their insulin. The device is quite futuristic, bringing to mind the injections the crew received on the television show, Star Trek, in that they deliver the insulin by way of high pressure air. It sends the insulin using a fine spray that is delivered through the skin.

The Use of Insulin Pumps

This is a small device that is worn outside of the body. It is connected by tubing that is flexible and is inserted in the abdomen. It is easily programmed to dispense the proper amount of insulin. Typically, the patient will program the pump to deliver a steady dose of insulin. You can adjust it if more insulin is needed at a particular time. Those using an insulin pump as a delivery device should keep in mind that you can injure yourself or the insulin pump if it is worn when you are engaged in physical activity.



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