TuDiabetes Talks: The Insulin Express (podcast)

On this episode of TuDiabetes Talks Mila interviews Oren Liebermann and talk about his upcoming book “The Insulin Express” and his diagnosis story while traveling.


TuDiabetes Talks: Emotional health and diabetes

On this episode of TuDiabetes Talks, Mila will be talking with Mark Heyman Ph.D., Psychologist and new member of our Board of Directors. Mental Health is a topic we don’t hear a lot of, but it’s certainly one we can not forget.


TuDiabetes Talks: The Insulin Express

On this episode of TuDiabetes Talks Mila interviews Oren Liebermann and talk about his upcoming book “The Insulin Express” and his diagnosis story while traveling.

Learn more about Oren and his book at The Insulin Express

To purchase the book: Amazon


What is insulin?

Insulin is a hormone made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets make insulin and release it into the blood.

Insulin plays a major role in metabolism—the way the body uses digested food for energy. The digestive tract breaks down carbohydrates—sugars and starches found in many foods—into glucose. Glucose is a form of sugar that enters the bloodstream. With the help of insulin, cells throughout the body absorb glucose and use it for energy.

Insulin’s Role in Blood Glucose Control

When blood glucose levels rise after a meal, the pancreas releases insulin into the blood. Insulin and glucose then travel in the blood to cells throughout the body.

  • Insulin helps muscle, fat, and liver cells absorb glucose from the bloodstream, lowering blood glucose levels.
  • Insulin stimulates the liver and muscle tissue to store excess glucose. The stored form of glucose is called glycogen.
  • Insulin also lowers blood glucose levels by reducing glucose production in the liver.

In a healthy person, these functions allow blood glucose and insulin levels to remain in the normal range.

Types of Insulin

There are many different types of insulin. The type lets you know how fast the insulin starts working or how long it lasts in your body. Your health care provider will help you find the insulin that is best for you.

  • Rapid-Acting – This insulin starts working within 15 minutes after you use it. It is mostly gone out of your body after a few hours. It should be taken just before or just after you eat.
  • Short-Acting – This insulin starts working within 30 minutes to 1 hour after you use it. It is mostly gone out of your body after a few hours. It should be taken 30-45 minutes before you eat.
  • Intermediate-Acting – This insulin starts working within 2-4 hours after you use it. It reaches its highest level in your blood around 6-8 hours after you use it. It is often used to help control your blood sugar between meals. Some people use this type of insulin in the morning, at bedtime, or both.
  • Long-Acting – This insulin starts working within 2 to 4 hours after you use it. It can last in the body for up to 24 hours. It is often used in the morning or at bedtime to help control your blood sugar throughout the day.
  • Pre-Mixed – This is a mix of two different types of insulin. It includes one type that helps to control your blood sugar at meals and another type that helps between meals.
General Tips
  • Never share insulin needles (syringes) or devices.
  • Ask your doctor or nurse to show you how to inject your insulin.
  • Always wash your hands before you inject your insulin.
  • Do not inject your insulin in the exact same spot on your body each time.
    • The skin may get thick or thin if you use the same spot.
    • Inject in the same general area of your body.
  • Do not use your insulin if it looks cloudy or looks like something is floating in it. Take it back to the drug store for a new one.
  • Do not use insulin needles (syringes), pens, and injectors after the expiration date printed on the label or on the box.

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Who should be part of your health care team?

 

Most people with diabetes get health care from a primary care professional. Primary care professionals include internists, family physicians, and pediatricians. Sometimes physician assistants and nurses with extra training, called nurse practitioners, provide primary care. You also will need to see other care professionals from time to time. A team of health care professionals can help you improve your diabetes self-care. Remember, you are the most important member of your health care team.

Besides a primary care professional, your health care team may include

  • an endocrinologist for more specialized diabetes care
  • a registered dietitian, also called a nutritionist
  • a nurse
  • a certified diabetes educator
  • a pharmacist
  • a dentist
  • an eye doctor
  • a podiatrist, or foot doctor, for foot care
  • a social worker, who can help you find financial aid for treatment and community resources
  • a counselor or other mental health care professional

When you see members of your health care team, ask questions. Write a list of questions you have before your visit so you don’t forget what you want to ask. Watch a video to help you get ready for your diabetes care visit.

You should see your health care team at least twice a year, and more often if you are having problems or are having trouble reaching your blood glucose, blood pressure, or cholesterol goals. At each visit, be sure you have a blood pressure check, foot check, and weight check; and review your self-care plan. Talk with your health care team about your medicines and whether you need to adjust them. Routine health care will help you find and treat any health problems early, or may be able to help prevent them.

Talk with your doctor about what vaccines you should get to keep from getting sick, such as a flu shot and pneumonia shot. Preventing illness is an important part of taking care of your diabetes. Your blood glucose levels are more likely to go up when you’re sick or have an infection. Learn more about taking care of your diabetes when you’re sick and during other special times, such as when you’re traveling.

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General Diabetes Information

What is insulin?

Insulin is a hormone made in the pancreas, an organ located behind the stomach. The pancreas contains clusters of cells ...
Read More

Who should be part of your health care team?

Most people with diabetes get health care from a primary care professional. Primary care professionals include internists, family physicians, and ...
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Know Your Diabetes ABCs – A1C, Blood Pressure and Cholesterol

Talk to your health care team about how to manage your A1C (blood glucose or sugar), Blood pressure, and Cholesterol. This will help ...
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How to manage your diabetes?

Healthy eating, physical activity, and insulin injections are the basic therapies for type 1 diabetes. The amount of insulin taken ...
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What is Prediabetes?

Prediabetes is a condition in which blood glucose or A1C levels—which reflect average blood glucose levels—are higher than normal but ...
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Diabetes symptoms

Individuals can experience different signs and symptoms of diabetes, and sometimes there may be no signs. Some of the signs ...
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Who is at risk of developing diabetes?

Type 1 diabetes risk factors: The risk factors for type 1 diabetes are still being researched. However, having a family ...
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What is diabetes? 

Diabetes is the condition in which the body does not properly process food for use as energy. Most of the ...
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Healthy Coping

Friends, Family, and Diabetes

One of the best ways to predict how well someone will manage diabetes: how much support they get from family ...
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Checks and Goals for Each Year

Once a Year Get a flu shot (October to mid-November), if you have not had negative side effects. Get a ...
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Managing Your Diabetes at Work, School, and During Travel

Staying in charge of your diabetes no matter what your day holds—work, school, travel, or special events—takes planning ahead. Many ...
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Self-care plan

Many people avoid the long-term problems of diabetes by taking good care of themselves. Work with your health care team ...
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How to help a loved one cope with diabetes

When people have the support of their family and friends, they are able to better manage their diabetes. It is ...
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What sexual problems can occur in men with diabetes?

Erectile Dysfunction

Erectile dysfunction is a consistent inability to have an erection firm enough for sexual intercourse. The condition includes the total inability to have an erection and the inability to sustain an erection.

Estimates of the prevalence of erectile dysfunction in men with diabetes vary widely, ranging from 20 to 75 percent. Men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not have diabetes. Among men with erectile dysfunction, those with diabetes may experience the problem as much as 10 to 15 years earlier than men without diabetes. Research suggests that erectile dysfunction may be an early marker of diabetes, particularly in men ages 45 and younger.

In addition to diabetes, other major causes of erectile dysfunction include high blood pressure, kidney disease, alcohol abuse, and blood vessel disease. Erectile dysfunction may also occur because of the side effects of medications, psychological factors, smoking, and hormonal deficiencies.

Men who experience erectile dysfunction should consider talking with a health care provider. The health care provider may ask about the patient’s medical history, the type and frequency of sexual problems, medications, smoking and drinking habits, and other health conditions. A physical exam and laboratory tests may help pinpoint causes of sexual problems. The health care provider will check blood glucose control and hormone levels and may ask the patient to do a test at home that checks for erections that occur during sleep. The health care provider may also ask whether the patient is depressed or has recently experienced upsetting changes in his life.

Treatments for erectile dysfunction caused by nerve damage, also called neuropathy, vary widely and range from oral pills, a vacuum pump, pellets placed in the urethra, and shots directly into the penis, to surgery. All of these methods have advantages and disadvantages. Psychological counseling to reduce anxiety or address other issues may be necessary. Surgery to implant a device to aid in erection or to repair arteries is usually used as a treatment after all others fail.

Retrograde Ejaculation

Retrograde ejaculation is a condition in which part or all of a man’s semen goes into the bladder instead of out the tip of the penis during ejaculation. Retrograde ejaculation occurs when internal muscles, called sphincters, do not function normally. A sphincter automatically opens or closes a passage in the body. With retrograde ejaculation, semen enters the bladder, mixes with urine, and leaves the body during urination without harming the bladder. A man experiencing retrograde ejaculation may notice that little semen is discharged during ejaculation or may become aware of the condition if fertility problems arise. Analysis of a urine sample after ejaculation will reveal the presence of semen.

Poor blood glucose control and the resulting nerve damage can cause retrograde ejaculation. Other causes include prostate surgery and some medications.

Retrograde ejaculation caused by diabetes or surgery may be helped with a medication that strengthens the muscle tone of the sphincter in the bladder. A urologist experienced in infertility treatments may assist with techniques to promote fertility, such as collecting sperm from the urine and then using the sperm for artificial insemination.

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What is hypoglycemia and how to treat it?

Hypoglycemia, also called low blood glucose or low blood sugar, occurs when the level of glucose in your blood drops below normal. For many people with diabetes, that means a level of 70 milligrams per deciliter (mg/dL) or less. Your numbers might be different, so check with your health care provider to find out what level is too low for you.

What are the symptoms of hypoglycemia?

Symptoms of hypoglycemia tend to come on quickly and can vary from person to person. You may have one or more mild-to-moderate symptoms listed in the table below. Sometimes people don’t feel any symptoms.

Severe hypoglycemia is when your blood glucose level becomes so low that you’re unable to treat yourself and need help from another person. Severe hypoglycemia is dangerous and needs to be treated right away. This condition is more common in people with type 1 diabetes.

Mild-to-Moderate

  • Shaky or jittery
  • Sweaty
  • Hungry
  • Headachy
  • Blurred vision
  • Sleepy or tired
  • Dizzy or lightheaded
  • Confused or disoriented
  • Pale
  • Uncoordinated
  • Irritable or nervous
  • Argumentative or combative
  • Changed behavior or personality
  • Trouble concentrating
  • Weak
  • Fast or irregular heart beat

Severe

  • Unable to eat or drink
  • Seizures or convulsions (jerky movements)
  • Unconsciousness
What causes hypoglycemia in diabetes?

Hypoglycemia can be a side effect of insulin or other types of diabetes medicines that help your body make more insulin. Two types of diabetes pills can cause hypoglycemia: sulfonylureas and meglitinides . Ask your health care team if your diabetes medicine can cause hypoglycemia.

Although other diabetes medicines don’t cause hypoglycemia by themselves, they can increase the chances of hypoglycemia if you also take insulin, a sulfonylurea, or a meglitinide.

What other factors contribute to hypoglycemia in diabetes?

If you take insulin or diabetes medicines that increase the amount of insulin your body makes—but don’t match your medications with your food or physical activity—you could develop hypoglycemia. The following factors can make hypoglycemia more likely:

Not eating enough carbohydrates (carbs)

When you eat foods containing carbohydrates, your digestive system breaks down the sugars and starches into glucose. Glucose then enters your bloodstream and raises your blood glucose level. If you don’t eat enough carbohydrates to match your medication, your blood glucose could drop too low.

Skipping or delaying a meal

If you skip or delay a meal, your blood glucose could drop too low. Hypoglycemia also can occur when you are asleep and haven’t eaten for several hours.

Increasing physical activity

Increasing your physical activity level beyond your normal routine can lower your blood glucose level for up to 24 hours after the activity.

Drinking too much alcohol without enough food

Alcohol makes it harder for your body to keep your blood glucose level steady, especially if you haven’t eaten in a while. The effects of alcohol can also keep you from feeling the symptoms of hypoglycemia, which may lead to severe hypoglycemia.

Being sick

When you’re sick, you may not be able to eat as much or keep food down, which can cause low blood glucose. Learn more about taking care of your diabetes when you’re sick.

How do I treat hypoglycemia?

If you begin to feel one or more hypoglycemia symptoms, check your blood glucose. If your blood glucose level is below your target or less than 70, eat or drink 15 grams of carbohydrates right away. Examples include

•four glucose tablets or one tube of glucose gel

•1/2 cup (4 ounces) of fruit juice—not low-calorie or reduced sugar*

•1/2 can (4 to 6 ounces) of soda—not low-calorie or reduced sugar

•1 tablespoon of sugar, honey, or corn syrup

•2 tablespoons of raisins

Wait 15 minutes and check your blood glucose again. If your glucose level is still low, eat or drink another 15 grams of glucose or carbohydrates. Check your blood glucose again after another 15 minutes. Repeat these steps until your glucose level is back to normal.

If your next meal is more than 1 hour away, have a snack to keep your blood glucose level in your target range. Try crackers or a piece of fruit.

*People who have kidney disease shouldn’t drink orange juice for their 15 grams of carbohydrates because it contains a lot of potassium. Apple, grape, or cranberry juice are good options.

Treating hypoglycemia if you take acarbose or miglitol

If you take acarbose or miglitol along with diabetes medicines that can cause hypoglycemia, you will need to take glucose tablets or glucose gel if your blood glucose level is too low. Eating or drinking other sources of carbohydrates won’t raise your blood glucose level quickly enough.

What if I have severe hypoglycemia and can’t treat myself?

Someone will need to give you a glucagon injection if you have severe hypoglycemia. An injection of glucagon will quickly raise your blood glucose level. Talk with your health care provider about when and how to use a glucagon emergency kit. If you have an emergency kit, check the date on the package to make sure it hasn’t expired.

If you are likely to have severe hypoglycemia, teach your family, friends, and coworkers when and how to give you a glucagon injection. Also, tell your family, friends, and coworkers to call 911 right away after giving you a glucagon injection or if you don’t have a glucagon emergency kit with you.

If you have hypoglycemia often or have had severe hypoglycemia, you should wear a medical alert bracelet or pendant. A medical alert ID tells other people that you have diabetes and need care right away. Getting prompt care can help prevent the serious problems that hypoglycemia can cause.

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TuDiabetes Talks: Emotional health and diabetes

On this episode of TuDiabetes Talks, Mila will be talking with Mark Heyman Ph.D., Psychologist and new member of our Board of Directors. Mental Health is a topic we don’t hear a lot of, but it’s certainly one we can not forget.


Questions to Ask about Your Diabetes Medicines

Ask your doctor these questions when you get a prescription for a medicine. Make copies of this insert and use one sheet for each of your medicines.

  1. What are the names of my medicine?

    Brand name:

    Generic name:

  2. What does my medicine do?
  3. When should I start this medicine?
  4. This medicine is prescribed by:
  5. How long will it take this medicine to work?
  6. What is the strength (for example, how many milligrams, written as mg)?
  7. How much should I take for each dose?
  8. How many times a day should I take my medicine?
  9. At what times should I take my medicine?
  10. Should I take it before, with, or after a meal?
  11. Should I avoid any foods or medicines when I take it?
  12. Should I avoid alcoholic beverages when I take it?
  13. Are there any times when I should change the amount of medicine I take?
  14. What should I do if I forget to take it?
  15. If I’m sick and can’t keep food down, should I still take my medicine?
  16. Can my diabetes medicine cause low blood glucose?
  17. What should I do if my blood glucose is too low?
  18. What side effects can this medicine cause?
  19. What should I do if I have side effects?
  20. How should I store this medicine?

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