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Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs) with insulin. Apidra® is a rapid-acting insulin analog indicated to improve glycemic control in adults with type 2 diabetes or adults and children (4 years and older) with type 1 diabetes.
When used as a mealtime insulin, the dose of Apidra® should be given within 15 minutes before or within 20 minutes after starting a meal. Click the CONTINUE button below to go to the Macromedia Flash Player Download Center, or the CANCEL button to return to the previous page. When you’re prescribed a new diabetes drug, ask your doctor which side effects to look out for. Type 1 diabetes, once called juvenile diabetes or insulin-dependent diabetes, is usually first found in children, teenagers, or young adults. Type 2 diabetes, once called adult-onset diabetes or noninsulin-dependent diabetes, is the most common form of diabetes. Insulin helps keep blood glucose levels on target by moving glucose from the blood into your body’s cells.
Hypoglycemia is the most common and serious side effect of insulin, occurring in type 1 and type 2 diabetics.
Symptoms of low blood sugar(Hypoglycemia) can be mild, such as a feeling of lightheadedness, but can also be severe. Insulin overdose can occur if you use too much insulin or if you use the right amount of insulin but eat less than usual or exercise more than usual.
Because the insulin is administered by the use of a needle, people can develop side effects to the injection site. Since insulin can’t be swallowed—digestive enzymes break it down before it can reach the bloodstream—it must be injected, whether you’re afraid of needles or not. Also, insulin is injected into the fatty tissue of the abdomen, upper arm or hips, where there are few nerve endings. Most FDA-approved insulin formulations are carefully calibrated so as not to cause hypoglycaemia but when blood sugar does drop, there are many strategies for managing it. Learning the early signs—such as sweating, heart palpitations, hunger and feeling weak or faint—allows you to stop hypoglycemia in its tracks.
If you’ve been on insulin therapy for many years and stop experiencing the early warning signs, you may be in danger of serious hypoglycemia (which can cause loss of consciousness). If you eat the same amount of food as you did before you started taking insulin, you will likely gain weight. Work closely with your doctor and a nutritionist to take the steps necessary to prevent weight gain. Some doctors will add the injectable medication pramlintide, which makes insulin more effective by blocking glucose release by the liver and slowing the emptying of the stomach, which, in turn, produces a feeling of fullness. Silicone-coated needles This new breed of smaller, thinner insulin needle coated with silicone can make injections virtually painless.
Pens Pre-filled disposable insulin pens have tiny needles and are easy to use and more discreet than a syringe. Rapid-acting insulin By beginning to work just five minutes after it is injected, and lasting approximately two to four hours, rapid-acting insulin allows some diabetics more flexibility when timing meals. Room-temperature insulin This insulin can be safely stored at room temperature and doesn’t require refrigeration, providing diabetics a greater degree of freedom and convenience. A. Diabetics should be instructed on glucose monitoring, proper injection technique, and the management of hypoglycemia and hyperglycemia. D.Diabetics  need to speak to their doctor or health care professional if pregnant or if they intend to become pregnant.
If some combination of losing weight, making dietary changes and exercising doesn’t help a Type 2 diabetic achieve target blood sugar levels, a doctor will prescribe oral antidiabetic medications.
Along with meal planning and physical activity, diabetes pills help people with type 2 diabetes or gestational diabetes keep their blood glucose levels on target.
If your doctor suggests that you take insulin or another injected medicine, it doesn’t mean your diabetes is getting worse. Many types of diabetes pills can help people with type 2 diabetes lower their blood glucose. A variety of different diabetes drugs are available, with each performing a different function. Generic names for some of the more common sufonylureas are glimepiride, glyburide, chlorpropamide, and glipizide. Some sulfonylureas work all day, so you take them only once a day – usually before breakfast.
Known under the generic name metformin (met-FOR-min), this drug helps lower blood glucose by making sure your liver does not make too much glucose. Metformin can improve blood fat and cholesterol levels.  Also, metformin does not cause blood glucose to get too low (hypoglycemia) when it is the only diabetes medicine you take.
Some possible side effects of metformin include nausea, diarrhea and other stomach symptoms, weakness or difficulty breathing, or a metallic taste in the mouth. People with kidney problems and people who drink more than 2-4 alcoholic drinks per week should not take metformin.
Known under the generic names acarbose and miglitol, these medicines block the enzymes that digest the starches you eat. Neither acarbose nor miglitol causes hypoglycemia when it is the only diabetes medicine you take. Sold under the generic names pioglitazone and rosiglitazone, these pills help make your cells more sensitive to insulin.
Pioglitazone is usually taken once a day, while rosiglitazone is taken either once or twice a day, with or without a meal. Possible side effects of pioglitazone or rosiglitazone include weight gain, anemia, and swelling in the legs or ankles.
If you take birth control pills, medicines in this group might make your birth control pills less effective, which increases your chances of getting pregnant. Known under the generic names repaglinide and nateglinide, this pill helps your pancreas make more insulin right after meals, which lowers blood glucose. If you need medical tests that require using dyes, or if you are having surgery, your doctor will tell you to stop taking this medicine for a short time.
Reduces the amount of sugar made by your liver after you eat, when your body doesn’t need it.
Sitagliptin can be taken alone, or in combination with other diabetes pills such as metformin, or sulfonylureas. Sitagliptin is also combined with metformin into a single pill, sold under the brand name Janumet. Possible side effects include upper respiratory tract infection, stuffy or runny nose and sore throat, and headache.
The goal of these oral medications is to help the body stimulate and use insulin more effectively and to lower blood sugar. Eventually most type 2 diabetics who don’t lower their blood sugar levels will stop producing insulin altogether. At this point, diet and exercise will not be able to reverse the effects of diabetes, and many type 2 diabetics will ultimately need insulin therapy (via injection) in combination with oral antidiabetic medications. Who can take it: Adults who have type 2 diabetes and haven’t had success with other treatment. What it does: After you eat, albiglutide helps your pancreas release insulin, which moves blood sugar (glucose) into your cells. Side effects: The most common ones are upper respiratory tract infection, diarrhea, nausea, and skin reactions where you give yourself the shot.

What it does: Like other GLP-1 drugs, exenatide tells your pancreas to release insulin, which moves glucose out of your bloodstream and into your cells. Side effects: The most common ones include nausea, vomiting, diarrhea, feeling jittery, dizziness, headache, acid stomach, constipation, and weakness. Who can take it: Adults who have type 2 diabetes but haven’t had results with other treatment.
What it does: Like the other GLP-1 drugs, liraglutide cues your pancreas to release insulin.
All GLP-1 drugs, including liraglutide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. Who can take it: Adults with type 2 diabetes who have not had success with other diabetes treatment. What it does: Like other GLP-1 drugs, dulaglutide prompts your pancreas to release insulin, which moves glucose out of your bloodstream and into your cells. Side effects: The most common ones include nausea, vomiting, diarrhea, belly pain, and less appetite. One of the more surprising aspects of diabetes medications is how two people taking the same drug can have such different experiences.
One diabetic may have severe or troublesome side effects that make the drug intolerable, while another diabetic finds that the medicine does only the good that it is intended to do. To avoid some serious side affects ask to be prescribed drugs that have been on the market for at least seven years. Alternative therapies for diabetes are treatments that are neither widely taught in medical schools nor widely practiced in hospitals.
Alternative treatments that have been studied to manage diabetes include acupuncture, biofeedback, guided imagery, and vitamin and mineral supplementation. Acupuncture is a procedure in that a practitioner inserts needles into designated points on the skin. Biofeedback is a technique that helps a person become more aware of and learn to deal with the bodys response to pain.
The most effective methods of treatment for diabetes particularly Type 2 diabetes is exercise, physical therapy and healthy diet changes . Some Type 2 diabetics can minimize side effects or avoid drugs altogether by losing weight, exercising more , stopping smoking and cutting down on alcohol. A doctor may adjust the dosage,change the medication or offer tips to make you more comfortable.
Diabetes needs to be monitored and treated continuously to prevent future debilitating problems. If there is any topic you would like to see covered in this site please let me know all feedback is welcome! Thanks so much for your helpful comment your advice will give readers peace of mind knowing they can turn to their pharmacist and doctor if they are concerned about the possible side-effects of medications.. Determining starting basal rates of insulin infusion for insulin pump users: a comparison between methods -- Chow et al. Results For type 1 diabetes, patient weight and TDD of long-acting insulin correlated with final basal rates. With this in mind, we sought to investigate presently established guidelines for basal rate estimations.
3a€…months, with records of glycated hemoglobin (HbA1c), insulin dosage and weight available from before and after pump initiation.
This was based on the observation that many of these patientsa€™ titrated basal rates appeared to converge on this single value. CSII therapy for 41a€…months on average, while all type 2 data were collected after 4a€…months. Distribution of the absolute percentage differences of each basal rate estimate to final basal rates.
Distribution of the percentage differences of each basal rate estimate to final basal insulin rates. Data sharing statement Original raw data are encrypted and will be kept on file at the site of collection for 5a€…years after publication. Due to its progressive nature, many people with type 2 diabetes will eventually require insulin treatment.
It is usually beneficial to include the patient’s partner or family in discussions about insulin initiation. Isophane - recommended as the first-line insulin treatment for type 2 diabetes in New Zealand.
Patients require adequate education and training before they begin SMBG and self-administering insulin. There are several different kinds of blood glucose testing meters currently fully subsidised. Each type of blood glucose meter requires the use of specific blood glucose testing strips.
Insulin is always administered by subcutaneous injection, with a pen (3 mL cartridges) or syringe (10 mL vials). I am disappointed that one can't do the BPAC Quiz questions for the older BPAC publications in retrospect! The Apidra® No Co-Pay offer is not valid for patients whose prescriptions are paid in part or full by any state or federally funded programs including but not limited to Medicare, Medicaid, Medigap, VA, DOD or TriCare. Apidra® given by subcutaneous injection should normally be used in regimens that include a longer-acting insulin. For example, some diabetes medicines can cause nausea or an upset stomach when you first start taking them.
No two people respond the same way to the same medication, so it’s impossible to know if you’ll experience a certain side effect before taking the drug.
It can start when the body doesn’t use insulin as it should, a condition called insulin resistance.
An insulin pump is a small machine about the size of a cell phone, worn outside of your body on a belt or in a pocket or pouch.
The jet injector, which looks like a large pen, sends a fine spray of insulin through the skin with high-pressure air instead of a needle. Some people with diabetes who use insulin need to take it two, three, or four times a day to reach their blood glucose targets. As the medicine enters the tissues under the skin, it can cause local inflammation and irritation. The needles used today are extremely thin and coated with silicone, so they slide in more easily. Treat early signs with four ounces of orange juice, or up to five glucose tablets—and call your doctor. Keeping glucose tablets and pre-filled glucagon syringes on hand—if your doctor agrees—will ensure you’re prepared to keep your blood sugar at a healthy level. While it does have the potential to cause weight gain, it poses no more of a weight risk than oral blood-glucose-lowering medications. The best way to prevent it is to modify your diet and increase physical activity once you start insulin, in order to help you achieve a healthy weight.
Instead, it means you need insulin or another type of medicine to reach your blood glucose targets.
Many people with diabetes have to take more than one type of pill, with some taking pills which combine two types of drug in one tablet. Your doctor will tell you which meals to take it with.  There is an extended release version of metformin which is taken once a day.

This action causes a slower and lower rise of blood glucose through the day, but mainly right after meals. Call your doctor right away if you have any signs of liver disease: nausea, vomiting, stomach pain, lack of appetite, tiredness, yellowing of the skin or whites of the eyes, or dark-colored urine.
Repaglinide lowers blood glucose the most one hour after you take it, and it is out of the bloodstream in three to four hours. All GLP-1 drugs, including albiglutide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. All GLP-1 drugs, including both types of exenatide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. If you get dehydrated from nausea, vomiting, or diarrhea, that could lead to kidney failure.
Other side effects include less appetite, vomiting, stomach pain, tiredness, dizziness, or indigestion. You can take it alone, or in combination with metformin, pioglitazone, or a sulfonylurea drug.
It also limits how much of the hormone glucagon your body makes, since glucagon normally spurs your liver to release stored sugar.
All GLP-1 drugs, including dulaglutide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. You should bring this medication journal with you each time you visit a doctor or if you are admitted to a hospital. It often takes five to 10 years for serious side effects of a new drug to show up in the general population. Some researchers believe that acupuncture triggers the release of the bodys natural painkillers.
A person may also include the images of controlling or curing a chronic disease, such as diabetes. If your grandparents are not fastidious about this they could end up blind, on dialysis, missing limbs etc. The new technology that is emerging in the field of diabetes has really made life easier for those who suffer with it. If your doctor is not available to answer questions or worries about medication and side effects, a pharmacist will usually know the answer and can guide you by performing a medicines review. These 4 methods were subsequently compared in their accuracy and potential risk of hypoglycemia. The dawn phenomenon, well established in CSII research,19 ,20 is recognized as one such challenge in pump patient management. An eight step process has been linked to an electronic decision support tool used by many practices. Alcohol consumption should be moderate as this increases the risk of hypoglycaemia in patients taking insulin. This can be done before each meal and ideally, two hours after the evening meal and breakfast.
Software can also be downloaded from manufacturers allowing analysis of blood glucose readings on home computers. Sometimes one just doesn't get around to it at the time even if one does some or all of the reading! Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Before you start a new medicine, ask your doctor about possible side effects and how you can avoid them. If the body can’t keep up with the need for insulin, you may need diabetes medicines. In people who don’t have diabetes, the body makes the right amount of insulin on its own.
If you have any symptoms of hypoglycemia, follow your doctor’s instructions for what you should do if you develop hypoglycemia. Other effects include rapid breathing, breath that smells fruity, increased urination or extreme thirst.  if you experience these symptoms you may need to speak with your doctor in order to adjust your insulin dosage. But sometimes the fear goes much deeper: Some are concerned that injecting insulin means their disease is getting worse. It is important to discuss the risks and benefits of a drug with your doctor before starting any therapy. This fast action means you can vary the times you eat and the number of meals you eat more easily using repaglinide than you can using other diabetes pills. Exactly which class of drug your health care practitioner prescribes for you will depend on your individual situation, your blood glucose levels and any side effects you may experience.
If you think you could get pregnant, tell your doctor, since researchers haven’t studied this drug in pregnant women. It helps your body release more insulin and move glucose from your bloodstream into your cells.
People using this technique believe their condition can be eased with these positive images.
This can check you are on the right dose, look for interactions between medicines and supplements, and generally put your mind at rest – or refer you to your doctor if needed. However, New Zealand guidelines now recommend that insulin initiation for people with type 2 diabetes be managed in primary care where possible, with additional support as required. Quizzes expire after approximately two years as they may no longer refer to the latest information about a topic. As with all insulin preparations, the time course of Apidra® action may vary by individual or at different times in the same individual and is dependent on many conditions, including the site of injection, local blood supply, or local temperature.
But when you have diabetes, you and your doctor must decide how much insulin you need throughout the day and night.
Your doctor or diabetes educator will help you learn how and when to give yourself insulin.
What works best for you depends on your usual daily routine, eating habits, and activities, and your other health conditions. It’s possible you could get low blood sugar or have an allergic reaction to the drug.
Actually, my grandparents have diabetes which makes them take so many medications everyday. Acupuncture is sometimes used by people with neuropathy, the painful nerve damage of diabetes.
The important thing is not to avoid needles but to do everything that’s in your power to control your diabetes and prevent damage to your nerves, eyes and other organs. In addition to controlling your A1C levels, pramlintide helps lessen your appetite, so you eat less. So far they are not experiencing any difficulties with this but I know sooner or later all the side effects will take place. Card carries a maximum offer benefit of $100 per prescription for the duration of the program.

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