I really do try to draw interesting questions from you, the real people who have diabetes. A week of teaching goes by quickly and I hear some legitimate concerns from patients and their desire to do the best job they can to take care of themselves. I know no questions are silly or redundant when it comes to being involved in your treatment plan so hopefully you too can learn from others dealing with similar situations.
- I know that I am supposed to move my insulin shots around but I do not have a specific plan and I do not know why one site is preferred over another.
Answer – The main sites of an insulin injection are the abdomen, the upper outer arms, the upper outer thighs and the fleshy part of the back of the hips. This week alone, I had a 6 people giving their insulin shots in the wrong places. The abdomen is still considered the best spot for an injection either a pen needle or syringe; it is easy to reach and the insulin is absorbed fast allowing it to get into your bloodstream quicker. The abdomen is least affected by exercise. Usually an arm or leg is utilized during exercise as in swimming and this could increase the chance of hypoglycemia. It is important to stay about 2 inches away from the belly button when using the abdomen and stay away from any abdominal scars. Rotate within the site but keep each site for a specific shot. An example would be a morning shot on the left side of the abdomen and an evening shot on the right side of the abdomen. If additional shots are needed, add another site and keep them consistent. This helps prevent hard lumps form forming under the skin and gives you the best opportunity for good insulin delivery.
- I know that lancets for my finger sticks with my glucose meter are cheap and I have tons of them but I am too lazy to change them and I don’t feel like it makes a difference. I never get an infection.
Answer – The biggest reason that you should change lancets after each stick is so you can get the sharpest stick each and every time. The sharpest stick should not be more painful. Actually, the more times you use the lancet, the duller it becomes and the more painful it will be. These lancets are covered with silicone and after one stick the coating wears away. Also, with one stick per use, you will be able to get a good blood droplet the first time without squeezing the life out of your finger which may even dilute the droplet and give inaccurate results. Also, you do not want to waste strips with inadequate blood .You are at an increased risk for infection when using the lancet more than once.
- The same goes for my syringe needles, needles on my pens for insulin or my other diabetes injectables called Byetta, Victoza, or Bydeuron. I am sick of taking the time and energy to change them.
Answer – Diabetes educators do get it and we know you have multiple things to do in a day and anything to save a step or time seems fine. Unfortunately this can have an impact on your blood sugars .I had a patient last week who never changed the needle for the use of the entire insulin pen; she was having an impossible time controlling her blood sugars with results all over the place. The reason to change insulin syringe needles is the same as the lancets. The first stick is the sharpest with the least pain and the least chance for an infection. The reason for changing the pen needles is that they can leak insulin if not changed each time and you may not get the correct dosage. It can be confusing because you are supposed to prime the new needle before use with 1-2 units of insulin. Remember to change the needle and keep the needle off, with the pen cover on between injections to prevent leaking. Always dispose of lancets and needles responsibly by checking with your health department.
- The FDA came out with a policy to put a warning on the statin medication labels (Lipitor, Lescol, Mevacor, Altoprev, Livalo, Pravachol, Crestor and Zocor) which treat my LDL cholesterol. The warning states that they can increase blood sugar possibly cause diabetes if I have pre-diabetes, and may cause cognitive / memory problems. I also heard that statins can mess with my liver enzymes. I need so many blood tests as it is. Then there are the leg cramps! I guess I should stop taking statins because they have so many side effects.
Answer – Please, never stop taking any of your medications without consulting your physician. All medications certainly have side effects but the risks and benefits are always weighed out before a decision is made. Even now, with this new information staying on your statin is extremely important if you have diabetes. The leading cause of death from diabetes remains a heart attack or stroke; both conditions are reduced when taking a statin. Many leading cardiologists are stating that “the warning is necessary but should not be over stated and the benefits for most are still evident.”
Ask questions and get answers. Understand the answers and you will be more apt to do what is necessary to take proper care of yourself!
NOTE: Consult your Doctor first to make sure my recommendations fit your special health needs.
She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.
She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.