Diabetes is a disease that is estimated to affect 9 million Canadians which puts us at over 21% of our population being affected. There are projections that suggest that 25% of Canadians are affected by some form of the disease which includes Type 1, Type 2, Gestational Diabetes and Prediabetes . It has become clear that diabetes incidence has become very significant in North America. Like any disease where the goal of treatment is good management of target outcomes, the goal of good diabetes management is to maintain close control of blood sugars and to work to reduce or eliminate the secondary risks to major organ systems such as the heart, kidneys, liver, lungs, and the brain. Proper management includes becoming educated about the disease; including regular physical activity; good nutrition; weight management; proper medications – insulin for treatment of Type 1 and to some extent Type 2, but usually begins with hypoglycemic medications; lifestyle management which includes stress management and blood pressure management.
Any disease management program can only be done with the right tools, in particular the right diagnostic tools. Thankfully, we are living in an age when the technology to manage this disease is readily available and when incorporated into an intelligent diabetes management program, the incidence of injury to those major organ systems can be reduced or eliminated. With early diagnosis, comprehensive therapies and an aggressive management strategy can lead to positive health outcomes and ultimately the prevention of organ damage.
To do this then, you must have the right tools. This page describes those tools that are available to help you manage your diabetes.
Alcohol swab is a gauze pad which is saturated with alcohol. They are individually foil wrapped for easy to use convenience. They are used to cleanse the area of skin prior to an injection. Supplied in a box of 100 are designed to be used once and then discarded.
Blood Glucose Monitor
Blood glucose monitoring is a diagnostic tool useful in the management of diabetes. By poking your finger and placing a drop of blood on a test strip, you are able to measure the level of glucose in your blood. Normal range is 5.0 to 7.0 mmol/L,although your physician or diabetes educator may assign a different range based on your medical history.
The blood glucose monitor is able to provide you with valuable information. If you are not feeling well, test your blood sugar. It is best to rule out your blood sugar as the problem first and then work from there.
Never assume it is something else because that something else may affect your blood glucose level.
Diabetes is a dynamic disease and you may experience changes in how it is managed. Blood sugar increases or decreases when everything has remained the same such as diet or activity, may be a sign of a change in your condition. The information you gather by testing your blood sugar is invaluable information for your physician. These values may be used to make changes to your diabetes medications.
When traveling, particularly if you are driving, it is recommended to test more frequently. When you are sitting in a vehicle you may not be able to notice changes in your blood sugar. Blood glucose testing is a way to ensure your levels are within an acceptable range without guessing.
There is a wide selection of monitors to choose from. All require the use of a test strip manufactured by the same company that produces the monitor. You can not interchange test strips between different companies. All test blood from your finger or are calibrated for capillary blood. There are some monitors that have alternate site testing capabilities and the forearm is usually the site of choice.
Alternate site testing uses a different blood letting device cap. The value of alternate site testing is allowing your finger tips to have a break and heal. If you are testing four times a day, everyday, for twenty years, your fingers will be quite painful.
All blood glucose monitors provide a result within less than one minute. This result can be stored in the memory of the monitor or it can be written in a diabetes log. Which ever mechanism of recording is an individual choice, but this should be done every time you do a test. This information should be taken to your physician, these values allow for better management.
If you are doing a test and the reading seems quite different from others, it may be necessary to retest. Make sure you are using proper technique, wash your hands with warm, soap and water. If your fingers have residual traces of something you have eaten or touched, it can affect the test result. Remember, when you get a wacky test result always ask how do I feel? It is still just a machine. If you feel O.K. and the test result shows really high or low, it could be your technique. Always redo the test again.
Most blood glucose monitors have computer download capabilities. In order to utilize this feature, you will need to contact the company specific to your monitor. Computer access with your monitor is provided thru the manufacturer. This will allow you to graph your blood glucose and identify trends, etc. This is valuable for the technology savvy individual.
Diabetic log books are used to document blood glucose test results. They are pocket size and provided free of charge at most pharmacies.
Diabetic socks are non-binding pressure free socks for those who need or want a sock that does not constrict the leg or foot. They are made to be seamless to reduce any pressure sores or blisters and are made of 100% cotton for breathability.
This is important for someone with diabetes since numbness of the feet also known as neuropathy is a recognized complication. A diabetic with a neuropathy can not feel pressure or restriction. By the time it is recognized the damage may have been done. Another problem with diabetes is delayed healing. If a problem goes undetected, it can spell trouble for the diabetic.
Some physicians will recommend the diabetic only wear white socks. When the socks are removed at night, they should be turned inside out and inspected for any drainage. This allows the individual to check for any blood or any other suspicious markings.
We have all heard the story of the diabetic that presented to his physician for routine check. Only to find a nail in paled in the bottom of his foot and he was totally unaware. This illustrates the severity of a diabetic neuropathy.
Diabetic socks are available in different colors, sizes and in a padded sole or non padded sole.
Glucose tablets are used to manage low blood sugar levels in people with diabetes. When ingested they deliver an accurate dose of glucose and help to increase blood sugar levels. For the diabetic subject to low blood sugar levels, this is an invaluable tool for managing their levels.
Tablets are fat free, sodium free, gluten free, and caffeine free. Boost energy without extra calories. Available in a convenient tablet and a variety of delicious flavors.
An insulin pen is used to inject insulin for the treatment of diabetes. The pen requires a cartridge of insulin and a needle that is attached to the tip of the pen. By simply dialing to the dosage needed the pen is ready to deliver the prescribed amount of insulin.
Using an insulin pen provides a simpler and easier method of providing insulin. The pen is prefilled with insulin in the cartridge. This is much simpler than having to draw up insulin in a syringe and fussing with vials and swabs.
There are occasions when the pen may break or fail to function due to cracks if dropped. The insulin pens are provided free of charge by the insulin companies. Your local pharmacy usually stock these products.
The needles and alcohol swabs as well as the insulin cartridges are an ongoing expense. These will need to be purchased in order to continue to use your insulin pen. Check with your private insurance plan for coverage. A prescription from your family doctor will be required by your insurance plan.
Insulin is injected into the body rather than taken orally. The gastric contents break down insulin and make it inactive. Insulin needs to be given by a subcutaneous injection in to the back of the arms, legs, abdomen and buttocks.
The insulin syringes come equipped with a needle attached. The syringes are available in a 1/4cc, ½ cc and 1 cc depending on the amount of insulin you need. The syringe is marked with number of units, making it easier and more accurate to deliver the prescribed amount needed. The needles are short usually 5/16” or ½” and are a finer gauge usually 31G, or 29G.
Lancing Devices & Lancets
When diabetics are using a blood glucose monitor to check their blood, the lancing device is used to poke their fingers to access a drop of blood. Several companies manufacture the lancing devices and the replacement lancets. They are usually provided in the blood glucose monitor kits.
The lancet is loaded into the lancing device by removing the cap and placing the lancet in to the spring loaded holder. The cap is replaced and the level of penetration is selected by dialing the number you want. The larger the number the deeper the lancet will penetrate. The number 3 is a good place to start, and then you can work from there. If you are someone who has tough leathery fingers then the highest reading may be needed.
The number one question we are asked is do I need to change the lancet every time I use it. It is important to understand that the lancet after use is duller, covered with protein and tissue from the finger. Each poke with the same lancet can cause more discomfort and with proteins on the service attract bacteria. You will have to decide if you want increased discomfort and risk the chance of an infection.
The sharps containers is a plastic container made of puncture-resistance material. The needles and other medical sharps (such as scalpels) are placed for safe containment and disposal. They are available in different sizes to suite your needs, our stock items are 1.4L and 3.1L sizes. They are relatively inexpensive and provide a secure, safe disposal container for medical sharps.
After use they are dropped into the container without touching the outside, never push or force the medical sharps into the container to prevent damage and needle stick injuries. Sharps containers have a fill line to indicate the maximum level to which the container can safely be filled. Once full simply close the top with the lid provided. If you are not certain that the lid is secured, simply seal the lid some packing tape or Duct tape.
The disposal of the filled containers can be done by checking with your local pharmacy although in Alberta most pharmacies participate in the province wide EnviRx® program which is designed to provide a system of proper disposal for not just “dead drugs” but of consumer medical sharps. This program has been in place since the late 1990’s and gone through several versions, but continues to be funded by pharmacists, pharmacy organizations, government and industry partners. The program is designed to be at no charge to the consumer and continues to be so. Although statistics for sharps disposal are not available, the collection and disposal of “dead drugs” for the 2010 year was 55 metric tonnes, up from the previous year total of 43 metric tonnes.
Stafford Pharmacy & Home Healthcare has been an early adopter of the EnviRx® program and therefore accepts consumer sharps containers from any patient who can be identified to be a regular client at the pharmacy, no questions asked. If you do not normally purchase your injection or testing supplies from our pharmacy, talk with the pharmacy staff and most often arrangements can be made to dispose of your containers. We do not promote that any and all sharps containers will be accepted only because we have a limited capacity for the safe storage of these collection containers until they are picked up from our premises. There is no charge to the public for this service, therefore we must ensure that we do not incur additional costs due to a collection “over-commitment”. Outside of the EnviRx® program, the disposal of sharps containers would result in additional costs to the pharmacy for the pickup and removal of sharps collected from patients.