Injecting Insulin

Injecting insulin is the essential part of the daily regime for many Diabetics patient. Although insulin that can be inhaled is now available and approved, the reality is that most type 1 diabetics (and type 2 diabetics who require insulin) will have to continue injecting insulin until it is more common.

Tips for Injecting Insulin

Injection sites: Insulin should be injected into the layer of fat that lies right under the skin. There are several areas on the body where you can inject your insulin. These include the:

Abdomen (Stomach), a few inches away from belly button
Outer thigh
Hips
Upper Buttocks
Back of the arms

Painful Injection: Now a day’s super thin needles are available in the market, Insulin injection are pretty much painless, If you are finding that your injection hurt’s, Try the followings;

Use a new needle for every injection. It’s tempting to reuse needles, but they can become dull even after just one or two injections. And the duller the needle, the more painful the injection.
Use the thinnest needle possible. The higher the gauge, the thinner the needle.
Use a short needle (6 mm or shorter).
Inject insulin at room temperature.
If you use alcohol to clean your injection site, make sure it’s completely dry before injecting.
Relax tense muscles make the nerves in the injection area more sensitive.
Larger doses of insulin (30 units or more) may be uncomfortable. If this is a concern, talk with your doctor about splitting your dose.
Rubbing ice on your skin before injecting may also help.

Insulin leaking from injection sites: It’s not unusual for insulin to leak out from the injection site after you withdraw the needle. Usually, the amount that leaks out is insignificant and likely won’t affect your blood sugar levels. To minimize or avoid leakage, try the following:

Count slowly to 10 before withdrawing the needle.
After removing the needle, place your finger on the site for 5–10 seconds.
If you use a pen, always remove the needle after you inject. Leaving the needle on can cause air to enter the cartridge and it will take longer to inject the insulin.
Try injecting at a 45-degree angle rather than going straight in.

Forgetting to take you insulin: Missing even just one injection per week can raise your HbA1c level by 0.5%. How can you remember?

Link taking your insulin with other daily habits, such as eating breakfast or brushing your teeth before you go to bed.
Keep your insulin and supplies in a convenient place. And think about keeping supplies both at home and at work (or school).
Don’t get distracted. Multitasking is never a good idea, especially when it comes to injections. If you’re doing too many things at once, you can easily forget to inject. Focus on the task at hand.
Set an alarm, use sticky notes, ask your spouse to remind you — all can help you to remember.

Fear of Needles: Injection can lead to anxiety and even physical symptoms, such as light-headedness, palpitations, dry mouth, sweating, and feeling sick. Here’s what can be helpful:

Make sure you’re using the shortest, thinnest needle that you can.
An insulin pen may be easier for you to use than a syringe.
Put a cold spoon or an ice cube on the injection site for a few minutes before you inject.
Ask your doctor about using a topical anesthetic, which can numb the surface of the skin.

To read more on Patient Care, click on the link below.

Patient Care

Content Courtesy : Portea

Just Detected

Being diagnosed with diabetes can be an overwhelming experience In fact, it can be a major life stress for many people. This is especially true as most chronic conditions and progressive diseases can prove to be quite challenging to manage emotionally.

If you or your family are feeling anxious and disheartened, you should know that it is natural to feel that way. You should also know that you are not alone, and that 70 million other people in India are living with Diabetes. This is a condition that needs to be “managed”.

In brief, Diabetes is characterized by high blood glucose levels that result from defects in the body’s ability to produce enough insulin, and at times no insulin is produced at all. Insulin is required to remove sugars and toxins from our system, and when they do not get flushed out, they tend to accumulate, resulting in high blood glucose levels.

You will be happy to know there are countless cases of people who have reversed their condition simply by making changes in their daily lives, especially when it comes to food, exercise and stress management. With some precautions and care, we are confident that you too can be a winner.

Remember, with a clear plan, appropriate guidance, right (and on time) medications, timely tests and appropriate modifications to your lifestyle you can not only overcome your condition but stay on top of it. To know more, please refer to our Let’s Understand section

Remember, we are here to help you in your endeavour to stay focussed and on target!

Some quick tips that the American Diabetes Association and other bodies recommend that you should follow:

Find a good doctor
- We recommend seeking the advice of a specialist, in this case an ‘endocrinologist’ or ‘diabetologist’ who can help and direct you with a constructive plan of action. Check with your doctor if you have to repeat your tests.
Acquire as much information as you can
- An informed person can make better decisions. Therefore, it is essential for you to get to know more about food and other lifestyle changes that will help you manage better. Newly-diagnosed people are frequently advised to control blood sugar levels by following a healthy nutrition plan along with a regular exercise regime. To know more, read recommended diets and exercise plans for people living with diabetes.
Seek help and support from your family
- Research suggests that with family support one can manage diabetes much more effectively than running self-managed programmes. Your partner, family, and friends play a huge role in motivating you and helping you adhere to your diabetes management programme.
Make your own plan:
- As you may already know, food plays a very important role in diabetes management. An ideal diabetes meal plan consists of low carbs, low sugar, lean proteins and high fibre diet. You may choose from a wide variety of Diabetes meal plans available to you. Before you start following one, you are advised to check with your doctor or dietician regarding the amount of calories you need to take in a day/week, according to your BMI and physical activity rate.
  You may also seek a dietician’s advice to put together a plan that works best for you
Check on Alcohol and tobacco consumption
- Research suggests smoking may aggravate complications from Diabetes, such as heart diseases and may lead to nerve and kidney damage. It is, therefore, highly advisable to significantly limit or give up smoking.
  Alcohol consumption can have a strong impact on your blood sugar levels, not to mention liver-related disorders. It is a good idea to take your doctor’s advice on whether you can consume alcohol, and how much. In any case, please remember to always eat a meal while consuming alcohol to prevent fluctuations or spiking of blood glucose levels.
Medicines – on time, every time!
- One of the most crucial aspects of Diabetes management is to take your medication regularly and avoiding skipping meals. The medical explanation is that medicines and food have a direct role in keeping “good control” of blood glucose levels.
  If your doctor has advised you to take Insulin then please DO NOT skip your shots. Many people fear pain or scarring resulting from the Insulin shots, and the good news is that one can learn the right, less painful ways of taking Insulin. Refer to our “Insulin section” for more details.
  In fact, in order to keep your blood glucose levels in control, you should eat small meals more frequently and consult a dietician to plan the best possible meal plan for you.
Indulge yourself. Take extra care of your teeth to keep gum diseases at bay
- While it is true that you have to follow a strict plan, talk to your doctor about rewarding yourself once in a while.
  However, do keep in mind the fact that you have to keep up with your basic health and hygiene requirements. Do brush your teeth at least twice a day, as people living with Diabetes tend to have frequently-returning gum infections. You should also floss your teeth once a week and see a dentist at least twice a year. Inform your dentist if your gums bleed or get swollen to have the concerns addressed at the earliest.
Be careful about Wounds
- Take your wounds seriously, do go and see a doctor immediately if you feel your wounds are healing slowly, or not healing at all as high blood sugar can reduce blood flow, damage nerves and delay healing. It is essential to take care of your foot as minor cuts and blisters can lead to serious infections. Infact people living with Diabetes should also monitor for tingling or loss of sensation in the hands and feet.
Last but not the least
- With a strong determination and sincere effort, one can easily control Diabetes and enjoy living life like never before.
  Join the support community for family and friends of people living with Diabetes, a unique platform to share, help and bring a change in the lives of families and people living with Diabetes.

What can I do as a family/friend of a newly diagnosed loved one ?

As a partner or caregiver, it is understandable that your feel anxious and concerned on hearing the diagnosis of Diabetes.

Please be assured that there is no cause for concern as this is a condition that can be managed with a little care and diligence. You may need to play a pivotal role in the management of the condition for your partner or a loved one and therefore, you would need to be supporting and considerate. Research points to high success rates for diabetics that have had the support of a spouse or family member.

No need to panic
- While Diabetes is considered a lifelong “chronic” condition, there is no need to panic as it can be managed with lifestyle and diet changes. Please be caring and supportive as your partner/family member may have to depend on you to make the required changes and live a long and healthy life
Participate
- It is a good idea to actively participate in your partner’s plans and health goals. By working as a team your support is implicit. Set reminders to take medication on time, learn how to inject insulin, figure out what food items work and what don’t. Set realistic goals, and learn the fine art of encouraging without nagging.
De-stress yourself
- Diabetes can impact the whole family and not just the person living with the condition. In order to avoid the caregiver fatigue syndrome, it is a good idea to spend some time for you. Take timeout to pursue your own goals and keep up with your friends and associates outside of the Diabetic circle.

To read more on Diabetes, click on the link below.

Diabetes

Understanding Diabetes

What is Diabetes?

Diabetes is an endocrine disorder that elevates your blood sugar levels over a prolonged period of time. It is caused by the malfunctioning of the pancreatic cells, which produce insufficient or no Insulin.

Why is Insulin so vital ?

Insulin is the hormone that is responsible for the process that converts carbohydrates into sugar; which is then stored it in the body for future use. Insufficient or no secretion of insulin from our pancreas leads to an imbalance in the body, causing liver cells to convert glycogen to glucose and accumulate in the blood stream.

Indications of Diabetes

Some of the most common symptoms suggesting the onset of diabetes are frequent urination, frequent thirst, frequent hunger (even after full meals), unexplained burning, itching or rash in the body, specially the foot, bruising easily, slow healing of wounds or clotting of blood when the skin is broken/cut, tingling or numbness sensation in the extremities of the feet and hands as also extremely low energy levels. However, often these symptoms could go unnoticed leading to undetected diabetes. Hence, it is always a good idea to get yourself regularly checked by a doctor for preventive healthcare.

Why did I get Diabetes?

Leading Endocrinologist Dr Sanjay Kalra from Bharti Hospital, Karnal shares his perspective on why diabetes is spreading like an epidemic. Nearly 70 million Indians are living with diabetes today. This is not a small number. Our genetic make-up is tuned such as to store fat reserves in the body in order to survive severe weather conditons such as famine. In ancient times, these stored food reserves or lipids were converted into energy in the bodies of our ancestors, so that they could survive the harsh living conditions. Cut to the present generations, lifestyle, stress levels, sedentary life, lack of physical activity, unhealthy diets, all contribute to surplus reserves for the body. As a result, the pancreas gets overworked and starts malfunctioning.

Am I at Risk?

There are several factors which may cause diabetes but medical science is yet to ascertain the main cause responsible for a specific person. However research indicates that the following conditions make people twice more likely to get diabetes than those without these conditions.

It could be genetic, family history has a strong role. Other factors such as obesity, high blood pressure high triglyceride levels, presence of diabetes autoantibodies, substance abuse, or excessive consumption of alcohol and tobacco.

Diabetes Ranges

Age 20 and above amounts shown as mg/dL
Fasting	Less than 100
Before Meal	70-130
After Meal (1–2 hrs)	Less than 180
Before Exercise	If taking insulin at least, 100
Bed time	100-140
HbA1c	Less than or around 7.0 %

SOURCES: American Diabetes Association. “Standards of Medical Care in Diabetes—2014,” Diabetes Care, January 2014.

Shown above are blood glucose ranges defined by American Diabetes Association. You’re kindly advised to refer to a doctor as the values may differ slightly with different age & gender.

What is Prediabetes?

When the blood glucose levels are borderline or higher than what they should be. But not as high as people with diabetes is known as Prediabetes. This condition is a “whistle blower” and indicates that you may proceed towards diabetes type 2, if you do not make the necessary changes in your lifestyle.

What are the Types of Diabetes?

You may have already undergone tests and your doctor may have already explained if you have Diabetes, and if so, the specific type you are living with. As a general understanding, the following classifications should give a sense of various types of diabetes:

Type 1 Diabetes:
- Type 1 diabetes is when there is insufficient or no production of insulin in the pancreas. This condition requires external insulin to help your body convert sugars to energy.
Type 2 Diabetes:
- Type 2 diabetes is when the pancreatic cells, become insulin resistant due to a defective response in the receptor cells in the body. This is the most commonly found type worldwide.
Gestational Diabetes:
- Gestational diabetes is when blood sugar levels are raised during the time of pregnancy. This is most likely a temporary condition, in which blood sugar levels are often likely to come back to normal after the delivery.
Latent autoimmune diabetes in adults:
- LADA is when autosomal alterations can lead to defective BETA cell function, resulting in Type 1 diabetes. LADA is often misdiagnosed as Type 2 diabetes in India.

Complications

Diabetes is called as a silent killer because many people remain undetected till such time as the consistently high blood glucose levels start affecting other organs such as the heart, the kidney and the liver – referred to as Macro-vascular complications and the nervous system resulting in foot, gum or vision problems called Micro-vascular complications.

Check for other important co-morbid conditions:

Diabetic Retinopathy
Kidney Disorders
Diabetic Neuropathy
Chronic Vascular Disease
Liver Disorders
Erectile Dysfunction
Polycystic Ovarian Disease

What else do I need to know ?

Often many people remain undetected till such time that consistently high blood glucose levels have already started affecting other organs such as your heart, kidney, liver – referred to as Macro-vascular complications, and your nervous system resulting in foot, gum or vision problems called Micro-vascular complications.
If you are “suffering” from any other life style conditions, “co-morbid conditons” consult your endocrinologist/ diabetologist. Your doctor will prescribe specific medications and solutions to manage this or any other complication.