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Remember, taking your insulin correctly makes a big difference in your blood sugar. Use these easy ideas, or write down your own ideas to help you feel more comfortable about taking insulin.
NOTE: Living with Diabetes: An Everyday Guide for You and Your Family was produced by the ACP Foundation for patients with diabetes. Designed in a magazine format with lots of photos and a conversational style, the guide is an entirely new means of patient education in that the emphasis is on action (what patients need to do every day to manage their diabetes), rather than on an exchange of information. This guide is copyrighted and is available in both English and Spanish versions.
From the ACP Diabetes Care Guide
Practical tips for patients who are beginning insulin therapy.
Before you had diabetes, your body made enough insulin to keep your blood sugar normal. Now that you have diabetes, you may need to take extra insulin to help control your blood sugar.
NOTE: Living with Diabetes: An Everyday Guide for You and Your Family was produced by the ACP Foundation for patients with diabetes. Designed in a magazine format with lots of photos and a conversational style, the guide is an entirely new means of patient education in that the emphasis is on action (what patients need to do every day to manage their diabetes), rather than on an exchange of information. This guide is copyrighted and is available in both English and Spanish versions.
Type 1 diabetes mellitus (also called juvenile diabetes) occurs when the pancreas stops making insulin. Insulin helps the body use the energy in foods. Without insulin, blood levels of sugar become high. Over time, high blood sugar levels can lead to blindness, kidney failure, damage to nerves, and heart disease.
To keep blood sugar levels in the normal range, people with type 1 diabetes must inject insulin several times each day and follow a special diet. There are several types of insulin. Short-acting (regular or lispro) insulins begin to act soon after injection.
Long-acting (neutral protamine Hagedorn [NPH], lente, ultralente, or glargine) insulins do not begin to act until several hours after injection, but then they continue to act for many hours. For example, a dinnertime injection of long-acting insulin controls sugar levels throughout the night.
A very low blood sugar level (hypoglycemia) is a dangerous complication of insulin treatment. To avoid hypoglycemia during the night, doctors often tell patients to "split" their evening insulin dose by taking short-acting insulin at dinner and long-acting insulin at bedtime instead of taking both forms of insulin at dinnertime ("mixing").
However, nobody has done a careful study to see whether "splitting" is truly better than "mixing" the evening insulin.
Two lots of Accusure insulin syringes are being recalled by the manufacturer, according to an FDA alert. The syringes have been found to have needles that can detach from the syringe and become stuck in the insulin vial, push back into the syringe, or remain in the skin after an injection.
The syringes were distributed by Qualitest Pharmaceuticals between January 2007 and June 2008 and are labeled as Accusure Insulin Syringes 31 G-Short Needle, either 1/2 cc or 1 cc, lot number 6JCB1 or lot number 7CPT1. The lot number can be found on the white paper backing of each individual syringe. Anyone who has affected syringes should not use them and should contact Qualitest at 1-800-444-4011 for product replacement instructions.
Stolen vials of long-acting Levemir insulin (generic: insulin detemir) have reappeared and are being sold in the U.S. market, the FDA said in a news release.
About 129,000 vials were stolen and may not have been stored or handled properly, and thus may not be safe to use. At least one patient has suffered an adverse event due to poor glucose control after using a stolen vial. Patients should not use Levemir with the affected lot numbers of XZF0036, XZF0037 and XZF0038.
Disetronic Medical Systems Inc. is recalling ACCU-CHEK Spirit insulin pumps with up and/or down buttons that don't work, the FDA said in a release.
The buttons are used for changing the program in the menu or administering additional insulin. If they don't work, users may not be able to change any programmed setting on the pump. The recall applies to pumps with serial numbers from SN02119552 through SN10006093. Pumps with serial numbers including and above SN10006094 aren't affected and aren't being recalled.
Insulin pump users who experience button failure should call the ACCU-CHEK Spirit hotline at 1-800-778-5095.
The Agency for Healthcare Research and Quality (AHRQ) recently released new summary guides for the treatment of diabetes. The summary guides are a condensed synopsis of the available research on a specific condition. The guides are meant to aid both physicians and their patients, and each guide comes in two different versions tailored to each audience. The diabetes guides, Premixed Insulin Analogues: a Comparison with Other Treatments for Type 2 Diabetes for clinicians and Premixed Insulin for Type 2 Diabetes: a Guide for Adults for patients are available on the AHRQ Web site.
The newly approved OneTouch Ping Glucose Management System allows patients to calculate and deliver insulin doses without touching their pumps.
Manufacturer Covidien is recalling one lot of ReliOn hypodermic insulin syringes because of possible mislabeling that may cause patients to get up to 2.5 times the intended dose, the FDA said in a news release.
The extra dose of the single-use, disposable syringes could lead to hypoglycemia and/or death. The recall applies to lot number 813900 of the product labeled ReliOn 1cc, 31-gauge, 100 units for use with U-100 insulin. Some syringes labeled for use with U-40 insulin were mixed with these, packaged together, and sold at Wal-Mart and Sam's Club stores from Aug. 1 to Oct. 8.
Thus far, one adverse event has been reported to Covidien, which distributed 471,000 individual syringes of the recalled lot. Providers and patients can call (866) 780-5436 or go online for more information.
AHRQ released plain-language guides for consumers and clinicians comparing the efficacy, effectiveness, and side effects of newer premixed insulin analogues to conventional insulin (human insulin) and other preparations used to control Type 2 diabetes.
The consumer guide, called Premixed Insulin for Type 2 Diabetes: A Guide for Adults , is a primer on diabetes, diabetes testing, and treatments.
The clinician guide, called Premixed Insulin Analogues: A Comparison with Other Treatments for Type 2 Diabetes, includes additional information, including a confidence scale that rates available evidence.
Search MedlinePlus.gov from the National Library of Medicine for a variety of resources about insulin.
GlucoControl is a free PDA program (for Pocket PC), that helps patients to control the glucose levels in blood, replacing the classic diabetes notebook.
Due to the complexity of the system, this tool is recommended for advanced PDA users, only.
The Diabetes Log program is a complete tracking tool to help patients keep track of relevant information. Users can enter their BG level, insulin, activities, carbohydrate counts on each meal, etc.
GlucoTools is a set of tools for PalmOS-based PDAs that assist patients with diabetes who are using insulin. The system is geared primarily towards patients who use insulin pumps, but may also be useful for patients who are not using pumps, as well, since the system enables patients to double-check meal and correction boluses.
Enabling Tool
ACP Book/Publication
Annals of Internal Medicine
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