By KatIe BunKer
to a diabetes educator about insulin, only to find that you’ve been injecting it improperly all along? With the mass of information that’s dropped on your doorstep the day you’re diagnosed with diabetes, it’s easy to lose something in the shuffle. Here’s what the experts want to remind you.
5) Feel the burn? it affects how quickly Nope, it doesn’t really hurt. Most your insulin will kick in. If you just
that when the muscles near the injection
site are exercised shortly before or after a
shot, it will increase absorption rate.
2) it’s not unusual for type 2s to need insulin. You may need to add Blood Glucose MonItorInG
6) all meters are not created equal.
control your blood glucose. It doesn’t
8 mean that you’ve “failed” at managing meters vary quite a bit, do some research
Often, 3) there’s a right way to do it. Always educator before you buy.
7) accuracy matters. Be sure to use
top of the insulin vial with alcohol. Be
be able to sure to follow the directions for mixing
get a free your insulin if it’s NPH. Tap the syringe
blood to remove any air bubbles. It is also criti- blood glucose.
glucose cal to mix NPH well in an insulin pen.
8) Meters are often free—it’s the strips that’ll cost you. Often, you
will be able to get a free blood glucose
pressed and the needle under the skin for
5 seconds to make sure all the insulin has
bate from the manufacturer, or from your
health insurance company. The test strips
are another matter—they can be pricey,
4) cold insulin has a bite. Using insu- and you may need to check how many
is more likely to hurt than using insulin
9) Monitoring works. really. Ask your
should be stored at room temperature.
often you should check your blood glucose.
D i a b e t e s F o r e c a s t | a p r i l 2 0 0 8
until you get back up to 70 mg/dl. If you
monitoring frequency will vary depending are more than an hour away from a meal, upon your overall level of control and
least a small meal to ensure that hypogly-
10) even in the digital age, written 15) Yup, your boss could be your records help. You may have a lifesaver. If your blood glucose
meter that stores data electronically, but
it’s still a good idea to write down your
others around you. That’s why you have
to tell family, friends, and coworkers how
other variables as well, like food, exercise,
to recognize a low and help you treat it.
alcohol, and stress. You can then share this
and if so, make sure the people around you know how to use it. Call your
HypoGlyceMIa and HyperGlyceMIa
11) repeat after me: hyper = high, that indicates you have diabetes. hypo = low. In other words, MedIcatIons
16) When it comes to type 2 meds, You may one size does not fit all. There
12) Lows need glucose, highs need are six different classes of oral agents for off with insulin (or exercise). Know the
difference, because administering insulin
biguanides (metformin), dPP-4 inhibitors
will cause even lower blood glucose. For
(Januvia), meglitinides (Starlix, Prandin),
13) symptoms vary. Hypoglycemia Avandia). Some manufacturers produce
type 2 drugs into one pill, like Glucovance
weak, hungry, tingly, or confused. If you
17) older is sometimes better. The
the best options for everyone. You may be
ness, which increases the risk of severe
don’t be afraid to ask your doctor about
18) You’re an individual, not a
cause headache, blurry vision, thirst, fre-
statistic. Medications have
different effects on different people. If
14) it’s a numbers game, and the tes—for example, hypoglycemia unaware- Cko 15-15 rule is a winner. If you
for you, then you may be right. Be sure to
discuss those things with your health care
blood glucose again in 15 minutes. repeat provider. D i a b e t e s F o r e c a s t | a p r i l 2 0 0 8
19) it’s not a good idea to play doc- tor. Never discontinue a medica-
important to keep up with kidney function
care provider first. Be sure to talk to your
screenings before kidney failure occurs.
diabetes care provider about any problems 25) there’s a lot you can do.
20) Your pharmacist is your friend. avoid high-protein diets, and have your
issues, and may be able to save you time
and effort by contacting your doctor’s
pressure control is especially important for
office for refill authorizations. Also, your
urine (microalbuminuria and albuminuria).
medications you are on, and can alert you to potential drug interactions. your eyes
26) in young and middle-aged your KIdneys americans, most new blindness
21) Damaged filters don’t do the job. is due to diabetes. retinopathy, the most
to blindness. diabetes is responsible for
2 don’t filter the blood properly, and may 27) optometrists aren’t just for
blood 8eventually fail altogether. people with glasses. visit your
22) eventually, kidney damage can eye doctor every year for dilated eye and lead to kidney failure. It’s im-
28) Healthy blood glucose levels
ease is already in advanced stages. This is
are like carrots: both are good
why it’s important to keep up with annual for your eyes. Keeping up with blood
23) that specimen cup? You should developing eye disease and keeps existing carry it proudly. Once a year,
29)it’s worse under pressure. High
to check for microalbumin in your urine,
which if positive, indicates leakage of pro- to blood vessels in the eye, and can make dia-tein by the kidneys. This is an early sign
betic eye disease worse. Talk to your doctor
about ways to control your blood pressure.
30)cholesterol counts.
order other urine and blood tests to check
how well your kidneys are functioning.
damage to blood vessels in the eye. Keep anm
24) Kidney failure means dialysis or cholesterol down to keep eye disease from y s Chap a transplant. That’s why it’s so D i a b e t e s F o r e c a s t | a p r i l 2 0 0 8
Halacha and Psychological Treatment Dilemmas and Conflicts Seymour Hoffman, Ph.D. Abstract Two of the many issues that present halachic-treatment problems for the orthodox mental-health practitioner are the issues of honoring parents and treatment practices, and confidentiality and religious obligations. The clinical-religious aspects of the above are analyzed and discussed, via cor
“Nitroglycerin in a Crystal Goblet” Matthew 10:26-39, Jeremiah 20:7-13 Rev. Anne Weirich, January 20,2013 On New Year’s day, I saw a great documentary film called Searching for Sugar Man . It was produced in South Africa in 2012, and is up for an Oscar. If I gave away the end, a summary of the film could be a sermon in its entirety. My pastor friend that I saw the movie with walked ou