Q Should I keep Insulin in the refrigerator?
A: Unopened insulin should be stored in the refrigerator (at a temperature of 36 degrees to 46 degrees farenheight) until the expiration date noted on the product label.
Opened or insulin in use may be stored at room temperature (59 to 86 degrees farenheight) for a period of 1 month.
Any opened insulin should be discarded after 1 month.
Q What should my Blood Sugar's be?
A: A fasting blood sugar is recommended to be between 70 - 120 mg/dl.
Pre-meal blood sugar readings should be between 80-140 mg/dl.
A recommended bedtime blood sugar reading is between 120 - 140 mg/dl.
A recommeded 2 hour after eating blood sugar reading is between 140-180 mg/dl.
Q Will I ever be able to stop my insulin injections?
A: People with Type 1 diabetes make no insulin on their own. Insulin injections are necessary to provide this hormone that the body is on longer making. At present, an injection of insulin is the only way to provide this needed hormone. (there are clinical trials with inhaled insulin currently under investigation and this may be available in the future).
People with Type 2 diabetes do make some insulin in their body. This insulin may not meet their needs. If oral diabetes pills no longer can keep the blood sugar at recommended levels, insulin therapy is started. Some patients with Type 2 diabetes have been able to stop insulin injections when they have lost weight, started regular daily exercise and have changed their eating as directed by their physician.
Q: What should I do if I think I am having a low blood sugar?
A: If possible do a blood sugar test to confirm that your blood sugar is low (low blood sugars are below 70 mg/dl). If you do not have a blood sugar meter available to test, it is best to assume that your blood sugar is low and treat.
The best treatment for a low blood sugar is glucose gel or tablets (available at your pharmacy). Use the entire gel tube or 3-4 blucose tablets- this will generally raise blood sugar about 50 mg/dl. If your blood sugar is very low (under 40 mg/dl) you may need to double this amount.
If glucose tablets or gel is not available, 1/2 cup of juice or 1 cup of milk or 5 lifesavers will also generally raise blood sugar about 50 mg/dl.
It is best to test your blood sugar 15 minutes after treating your low blood sugar to see if blood sugar is rising. DO NOT DRIVE A CAR until blood sugar is over 100 mg/dl.
It is also advised to eat a meal or a significant snack shortly after treating your low blood sugar. (A low blood sugar treatment will usually only last or help for another 1/2 hour - this is especially important if you are taking long acting insulin.
Q: What should I do about my diabetes medication if I have a medical test or surgery?
A: If you know when you will be having a medical test or surgery, contact your doctor to see if the dose of your diabetes medication needs to be changed or held for that procedure. Most hospitals or out patient centers will provide you with a list of instructions for your procedure. Follow these instructions for best procedure outcomes.
If you are required to be on Clear Liquids for your procedure, you may have the following:
- Black coffee, decaf coffee, (May add sugar or sugar substitute, but no milk or cream)
- Broth
- Jello (Not sugar free)
- Clear juice such as apple, cranberry, and grape
- Popsicles (Not sugar free)
You may want to talk with the dietitian for the exact amount of these items needed to replace you usual foods.
Q When am I sick enough to call the doctor?
A: Illness usually makes blood sugar increase. Use the following guide to help you know when to call the doctor.
1. If you have (2) two blood sugar readings in a row that are 250 mg/dl or higher (even though you are still taking your diabetes medication). CALL THE DOCTOR.
2. For people with Type 1 Diabetes, check for ketones if your blood sugar is over 250 mg/dl. If ketones measure moderate to large, CALL THE DOCTOR.
3. If you are having difficulty breathing, CALL THE DOCTOR.
4. If you have vomited more than once today, or have had diarrhea more than (5) five times, or if either are lasting more than 24 hours, CALL THE DOCTOR.
Q: What should I do if I have Nausea and Vomitting and cannot take my insulin?
A: An individual with insulin treated diabetes can be potentially quite ill when nausea and or vomitting is present. Please do the following:
1. Check your urine for ketones. If it is moderate or large, call your doctor immediately. If your doctor is unavailable go to the emergency room. You potentially could be in diabetec ketoacidosis.
2. If you are ever so sick you cannot take your insulin you must call your physician. An individual with Type 1 diabetes always needs insulin.
Q: Is it all right to drink alcohol if you have diabetes?
A: Alcohol may be used with caution for people with diabetes. Do not use alcohol if you are on any medication which recommends you avoid alcohol. For many people, the use of alcohol increases the risk of a low blood sugar (for some up to 24 hours after drinking). It is advised that you eat if you will be drinking. Include the alcohol as part of a meal rather than drinking and eating a small snack.
Q: What foods are counted as Carbohydrates?
A: Foods that contain a large amount of carbohydrates are:
- Starches (Any food made from grain like breads, cereals, pastas, crackers, etc.)
- Starchy Vegetables (potatoes, peas, corn, lima beans, winter squash and dried beans, or lentils)
- Milk (as well as yogurt, pudding, ice cream)
- All fruits and fruit juices (whether they are sweetened or not)
- All forms of sugar (look for words that end in - ose or -ol)
Q: How many carbohydrates should a person have per meal?
A: In general most men can have 4 to 5 carb servings or 60-75 grams of carbohydrate at each meal.
Most women should have 3 to 4 carb servings or 45 to 60 grams of carbohydrate at a meal.
(A serving of carbohydrate = 15 grams of total carbs on a food label).
Q: Are Artificial sweeteners safe?
A: Yes, The FDA (Food and Drug Administration) is our watchdog for foods. All sugar substitutes or artificial sweetners must go through a rigorous process by FDA before they are available to the public. These sweeteners would not be available to purchase in the U.S. if they have not been approved as safe.
Q: Do I need to do anything special if I travel with my diabetes medicine and supplies?
A: Medication - Insulin doses may need to be changed if you will be traveling even for a distance of only 2-3 hours away. Check with your doctor for their recommendations.
Medication and Supplies - Should be kept in your carry on bag if you are flying, traveling by bus or train. It is usually best to take more supplies than you think you will need, just in case your return is delayed. You may want to carry a prescription for medication, syringes, test strips, lancets in case your supplies are lost during travel. Keep your medication and supplies in their prescription labeled containers for least hassle while traveling.
Delays - Carry some extra food, liquids, glucose tablets or gel in your travel bag in case of unexpected emergencies. The liquid meal repacement or meal bars work well (look for brands like Glucerna or Choice DM), these are individually packaged and do not require refrigeration.
Illness - It may be a good idea to have some over the counter medications for cough, cold, sore throat, diarrhea, packed in your travel bag just in case. Remember to wear your diabetes identification at all times when traveling.
(There is also a letter available at the doctors office to verify you are a diabetic patient and are carrying supplies necessary for treatment of diabetes).