Oral Therapy for Type 2 Diabetes

Transcription

1 Oral Therapy for Type 2 Diabetes Diabetes pills can help to manage your blood sugar. These pills are not insulin. They work to manage your blood sugar in several ways. You may be given a combination of medications. Always follow your doctor s instructions. Some pills may increase your risk for low blood sugar (hypoglycemia). Watch for symptoms of low blood sugar. Call your doctor if low blood sugar occurs often. Watch for Symptoms of Hypoglycemia Headaches Hunger Shakiness or dizziness A hard, fast heartbeat Cold, clammy skin; sweating Confusion or irritability Types of Diabetes Pills Prandin (Repaglinide), Starlix (Nateglinide), Glucotrol (Glipizide), Micronase (Glyburide), Amaryl (Glimepiride) These pills (meglitinides and sulfonylureas) help the beta cells in the pancreas release insulin, resulting in a lowering of blood sugar. This helps keep blood sugar levels in the target range. These pills can be taken one or two times a day or before a meal. Glyset (Miglitol), Precose (Acarbose) These pills (alpha-glucosidase inhibitors) help keep your blood sugar from rising too high after a meal. They are taken at the start of each meal. 13

2 (Oral Therapy for Type 2 Diabetes, continued) Actos (Pioglitazone) These pills (thiazolidinediones, or TZD for short) improve the body s response to the insulin that it already makes. This means that more sugar leaves the blood and enters the muscles and fat cells, where it belongs. This helps lower blood sugar levels. These pills are taken once a day. Glucophage (Metformin) These pills (biguanides) can also help improve the body s ability to use insulin. They are usually taken two times a day with food. Onglyza (Saxagliptin), Januvia (Sitagliptin) These pills (DPP-4 inhibitors) help lower blood sugar levels in people with type 2 diabetes. They are less likely to cause hypoglycemia. They are taken once a day. Glucorance, Kazano, Metaglip These medications (combination pills) may help keep your blood glucose within your target range. They also help your pancreas make more insulin and may help your muscles use insulin more effectively. Side effects depend on which type of combination you use. Your healthcare provider can tell you more. 14

3 Types of Insulin Insulin is a type of hormone. It helps the body use blood sugar (glucose) for fuel. You may need insulin injections to help manage your diabetes. With this condition, your body may not make enough insulin. Or, your cells may have trouble using insulin. There are many types of insulin that can be prescribed for your treatment. Most insulin is made in a lab. It s called human insulin because it s just like the insulin that s made in the body. Analog insulin When it s usually taken How soon it starts working* When its effect is strongest How long it lasts Fast-acting insulin Right before a meal 15 minutes 30 to 90 minutes 3 to 5 hours Long-acting insulin Premixed (mixture of fast-acting and intermediate-acting insulins) 30 minutes before the evening meal or at bedtime Before breakfast and/or before the evening meal 1 hour Steady over time Up to 24 hours 5 to 15 minutes Varies Up to 24 hours** Human insulin When it s usually taken How soon it starts working* When its effect is strongest How long it lasts Short-acting insulin (also called regular insulin) Intermediate-acting insulin (NPH) Premixed (mixture of short-acting [regular] and intermediate [NPH] insulins) 30 minutes before a meal 30 minutes before breakfast, the evening meal, or at bedtime 30 minutes before breakfast and/or before the evening meal 30 to 60 minutes 2 to 4 hours 5 to 8 hours 1 to 3 hours 8 hours Up to 24 hours 30 to 60 minutes Varies Up to 24 hours** *All times shown are approximate. **Check label. 15

4 Using Injected Insulin You can t take insulin by mouth because the acids in your stomach would destroy it. Most people take insulin by injection, or shots by syringe or pen. You may even have an insulin pump. Your healthcare team will show you how to give yourself insulin injections. Use the steps below as a reminder. Storing Your Insulin Insulin must be kept cool for it to work properly. Always keep it at below 86 degrees Fahrenheit, and never let it freeze! Always use insulin before the expiration date on the bottle. Throw bottles away after that date, even if you haven t opened them yet. Check the expiration date on insulin (this varies with the type of insulin). Write the date you opened it on the bottle, as a reminder. When you travel, take all of your supplies with you. Put them in an insulated bag, and keep the bag with you. Never put your supplies in luggage that you check on an airplane or a bus. Never leave insulin or needles in the car. They can get too hot or too cold or get lost. Prefilled Pens A prefilled pen looks like a writing pen. Many people like prefilled pens because they are disposable, discreet, and ready to use. Pen needles are often shorter and thinner than those used on syringes. That makes them practically pain free. The dosing dial helps you take the right amount of medicine. Many people who inject themselves with a syringe find the prefilled pen a good option. Syringes Filled from a Bottle of Insulin This is the oldest way to inject insulin. A syringe is a hollow tube with a plunger on one end and a needle on the other. You stick the needle into a bottle of insulin and draw up your dose. Syringes may not be convenient for people who need to inject insulin many times a day. 16

5 Getting Ready Wash your hands. Use soap and warm water. Gather your supplies. You need a clean needle and syringe, your insulin, alcohol wipes, and a sharps container. Clean the insulin bottle. Wipe the rubber stopper with alcohol. Prepare the insulin. If you use cloudy-type insulin, roll the bottle gently between your hands. Preparing the Syringe Note: If you mix insulin, put the clear insulin into the syringe first. Then put the cloudy insulin in. Pull back the plunger. Pull back until the end of the plunger is even with the number of units of insulin you take. Insert the needle into the top of the bottle. Hold the needle and bottle straight up and down. Then push the plunger in all the way. Turn the bottle and syringe upside down. Hold them in one hand. Turn your hand over so that the bottle is on top. Pull back on the plunger again. Pull back until the end of the plunger is even with the number of units of insulin you take. Remove the needle. Then tap the syringe with a fingertip to remove any air bubbles. If you use an insulin dial pen, dial to the number of units and proceed to next steps. Where to Place Your Injections Insulin is most often injected into the fat over the belly, where it is best absorbed. Change the injection site each time you give insulin. This helps prevent skin problems. Keep about 1 inch between sites. 17

6 Leave at least 2 inches around your belly button. Do not inject into broken or scarred skin or into broken blood vessels. Don t inject over or near a muscle you plan to exercise. Injecting the Insulin Clean your injection site using the alcohol wipes. Gently pinch up about 1 inch of skin. Do not squeeze the skin. Insert the needle into the location that you were taught to inject. Push in the plunger. Press until the syringe is empty. Let go of the skin. Then withdraw the needle. Don t rub the site after you remove the needle. Injecting the insulin Disposing of the Syringe After you inject, put the needle and syringe directly in a sharps container. Never lay them down anywhere and don t recap the needle. When the sharps container or empty bleach container is full, put it into a garbage bag and secure the top. Label the bag needles or sharps. Call your local waste company to ask about disposal requirements for needles. You can also check with the Coalition for Safe Community Needle Disposal at , SHARPS Dispose of the used needle right away in a sharps or empty bleach container. 18