Best Practices for Drug Prescriptions in Diabetes

Major therapeutic agents for the control of diabetes work safely and effectively only if used within rather narrow limits. A missed dose, an extra tablet, ill-health in an unrelated aspect, and other drugs can all affect your wellness dramatically.

All drugs for diabetes have to be taken with great care. You must not merely remember exactly when and how much to take, but you should be aware of possible side-effects and essential precautions as well.

It is nearly impossible for a patient to remember the complex instructions which should accompany every prescription by a doctor. That is why you should insist on written communication, in a hand and a language which you can read and understand. Each prescription is an important part of a medical record, so it is best to make copies for your files. Pharmacies may wish to preserve original prescriptions for their own records.

Here is a check-list of everything you should know, and information to which you should have immediate access at all times, before you start taking medicine to manage diabetes:

1. The chemical names of all active ingredients in drugs prescribed for you. Some doctors may prefer to prescribe brands, but you should know the generic names of drugs chosen for you.

2. The precise dose, timing, and sequence, in which medicines are to be taken.

3. Side-effects which are likely, others which are possible, and what you should do about them.

4. A list of all drugs which may interfere with your treatment.

5. Conditions in which your prescription needs changes.

6. Precautions related to pregnancy if you are a lady of child-bearing age.

7. How the medicines should be stored and what you need to do when you travel to a new place.

8. What you should do if you miss a dose, and what you must do in case you take too much of a drug, or repeat a dose by oversight. This also applies to a child or any other person accessing your medicines, and taking some of it in error.

9. Diet and exercise guidelines which have to accompany your drug regimen, and what you should do if you are forced to make deviations.

I can provide you with all this information if your physician refuses to do so. Just let me know the details of point 1 above. (Chemical names of medicines you have been prescribed).

Self-Care of the Vagina in Diabetes

I have to accuse nature of sexual discrimination in the matter of vulnerability to infections of the external genitalia! The penis does harbor some vermin at the tip, but they are easy to brush away if a man takes even minimal steps to keep the foreskin clean. This applies to the scrotum as well. Circumcision does a great job for hygiene quite apart from the religious significance.

The vagina is a different matter, with the perineum as an unwitting ally for invading bacteria. The female reproductive tract is built to harbor beneficial micro-organisms, but is structurally vulnerable to attack by pathogens. Women soon tire of treating white discharge with that horrible odor because the problem tends to recur frequently.

Diabetes adds to the travails of women who struggle to stay free of vaginal infections. Repeated episodes of attack do no good to blood glucose levels, and it can be embarrassing to keep asking a physician for help. However, neglect of an offensive discharge can have serious implications because colonies of pathogens will travel through the cervix in to the uterus and beyond.

Self-care of the vagina is easy, even if you have diabetes. The main thing is to keep the tract acidic. Wiping the perineum dry after bowel evacuation helps considerably as well. Finally, you can also insert colonies of harmless bacteria to prevent pathogen growth. Ask you gynecologist for long term solutions to keeping the vagina free of infection, which you can administer on your own. You can also email me for details. I can suggest products which you can assemble from pharmacies on your own, provided that your doctor agrees with my suggestions.

Bird Flu and Diabetes

No one wants to catch the bird flu or any other viral infection for that matter! However, people with diabetes need to be even more careful than others, because infections push up blood glucose levels, and often require adjustments in drug dosages.

Tamiflu is an important weapon in helping people affected by bird flu and some other types of influenza recover. The U.S. FDA has issued a December 2006 update of the Patient Information Sheet for Tamiflu. I accessed it today at the following link:

http://www.fda.gov/cder/drug/InfoSheets/patient/oseltamivir_phosphatePIS.htm#top

Do remember to ask your physician for precautions that you should observe, should you or someone in your family be prescribed a Tamiflu shot. Be especially careful when children are involved.

Write to me if you would like custom tips on what you can do to reduce the chances of a viral infection which could involve the risks of Tamiflu shots.

The Cultural Role of Peer Educators in Diabetes Management

Medicine may have global standards for detection and treatment, but all patients are not the same. Some ethnic groups have more red meat, saturated fats, sugar, and alcohol in their diets than others. Women from conservative backgrounds suffer from severe dress and freedom restrictions, which hamper their abilities to follow exercise regimens. Even language can prove to be an obstacle when it comes to understanding the nature of diabetes and the many complications of ignoring the disease.

Patients, who successfully control blood sugar, body weight, and lipids, even after being found to have diabetes, are the best educators for other members of their communities. Their diabetes diets and lifestyles may make little sense to people of other ethnicities, but the educational values are most high and relevant for others with similar habits. Peer educators make major contributions to the professional efforts of physicians in busy practices.

Try and join a support group of people like you, who also have diabetes, to share experiences and ideas in living well with the disease. Do as much as you can to have everyone tested at least once a year. Make an effort to find a guide who understands your food and lifestyle culture.

Write to me if you would like help with your diabetes diet, or if you would like to know more about the long term effects of this disease.

Please also share your recipes and solutions for diabetes management that suit a particular culture, at this forum.

Why Every Severe Headache in Diabetes Could Signal an Emergency

No one, least of all people with diabetes, should ignore pain. Neither bearing the discomfort nor suppressing sensations with self-medicated pain-killers, are the best ways to deal with sudden and severe episodes.

Headaches-the literal variety-are never a good sign. Unbearable pain is a part of migraine, which is a chronic condition. However, a splitting headache all of a sudden, could signal an emergency in diabetes, and needs immediate medical attention. Hopefully, the doctor will find that all is well, leaving you feeling a bit foolish about making a fuss over nothing and wasting time and money to boot. However, it could also save your life if the pain is due to damage to cranial nerves, or the start of an aneurysm burst. A history of poorly controlled diabetes or high blood pressure would add to the probabilities that a headache has serious origins. Nerves tend to decay if blood glucose is not controlled. An aneurysm is like a blister along the length of a blood vessel, and can lead to the formation of a clot or to heavy internal bleeding.

Keeping diabetes and blood pressure under control is always the best course to avoid serious health problems, but taking every sudden and severe headache seriously should be a part of your plan.

The 5-8 Hours Sleep Range for Diabetes Management

7 hours of sleep a day might be ideal to help with diabetes prevention and management. A study shows that people who sleep for less than 5 hours a day, or for more than 8 hours a day, are more likely to develop diabetes than others who sleep adequately but not excessively.

I accessed the following web page a few minutes ago, to read about possible links between sleep habits and diabetes:

http://www.webmd.com/content/article/120/113592.htm?z=1836_00000_5022_pe_02

Eating a large meal late in the evening and over-loaded schedules are the most common reasons for sleep disorders. Write to me if you do not sleep enough, or if you tend to spend too much time in bed. We should be able to find a path together to fix the problem.

A Fistful of Spiced Popcorn without Butter for Snack Craving in Diabetes

Munch each piece slowly and with relish. Your craving should die down, and you can even have a second fistful if the first helping does not work.

Ask your nutrition expert to build this snack in to your diabetes diet, and manage those times in-between meals when you can hardly resist sneaking in a bite.

Do remember that your diabetes diet will go for a toss if you eat more popcorn than provided in your plan, so it will pay to prepare individual sealed packets of the right portions, rather than to use a large container.

Here’s to healthy and planned snacking in diabetes!

3 Easy Steps to Avoid Respiratory Infections in Diabetes due to Poor Indoor Air Quality

No one wants respiratory infections, even if they do not have diabetes, but since blood glucose tends to rise when one is ill, people with diabetes need to take additional precautions to stay as free as possible from polluted air.

Allergens and pathogens may lurk in heated and air-conditioned spaces, whether at home or in an office. This is also the case with crowded public spaces, included those in aircraft and trains. There may not be much we can do about air quality in areas outside our control, but every effort to keep air clean in homes and work spaces is worthwhile. Here is a check-list of 3 things to integrate with your diabetes management plan:

1. Reduce smoke: cigarettes, pipes and cigars are obvious health hazards even for people who do not use tobacco, so the general trend towards restrictions on smoking in closed air systems deserves every encouragement. However, fire-places and cooking ranges also need attention because they are often considered to be fashionable, though they may contribute to respiratory distress in covert manner.

2. Carpets: they may look and feel good, but can provide shelter for germs and dirt, if not kept scrupulously clean. Things get a lot worse if there are hairy or furry pets around.

3. The HVAC AMC: it is easy to overlook the annual maintenance contract for your heating and air-conditioning system at home. There may be one for your office, but no one to check that it is done right. Do get certified technicians to climb in to ducts and to keep them looking like new from the insides, and have a microbiologist take spore and related counts of the ambient air your loved ones, colleagues, and you breathe everyday.

Frequent coughs and colds are easy to ignore but can wreck diabetes management plans. It pays to make the efforts needed to keep air clean, at least in areas under our control.

The Pros and Cons of Sushi in a Diabetes Diet

I will start with the pluses:

It looks great, tastes special, is full of variety, and can be filling. Your diet and nutrition specialist will be delighted to learn of your interest, because the nutrition value of sushi fit in with the profile of a typical diabetes diet very well indeed.

It has become a fashionable dining out choice as well, but sushi may not be a safe choice when eating way from home. Raw sea food, which is a common ingredient of many sushi recipes, is a source of pathogenic infections, and may contain traces of heavy metals and other pollutants as well.

It is easy to make sticky rice and to source deep-sea weeds: ask me for links if you do not know about these things as yet. You might not be as good as an expert chef at wrapping and plating initially, but you can learn fast if you make a habit of putting your own sushi together at home.

Fully cooked sea food, which has not been harvested from shallow waters near effluent discharge points, is better than the raw stuff of unknown origins, regardless of taste considerations.

Living with Diabetes is Now Easier in India

Amul, a leader in India’s market for vegetarian dairy products, has just launched a delicious range of frozen desserts, with sucralose instead of sugar. Choose from chocolate, strawberry, and a couple of delicious fruit flavors. The dessert comes with cultures of beneficial bacteria, which are good for health. Fat content is low, and the calories are about half that of regular ice-cream.

A scoop of this dream stuff takes you back to life before diabetes, and adds great pleasure and anticipation to the main meal of the day.

The company, which is owned by cooperatives of small farmers, has launched the brand with generous offers. Now all that remains is to rush to a store and lay your hands on some stuff before stocks run out.

My freezer is full!

Lasers, Gums, Teeth, and Diabetes

Oral care is an integral part of diabetes management. Periodontal conditions are more likely when patients have diabetes, and the threat of high blood sugar is always a reason when it comes to bacteria hiding in the cracks and crevices inside the mouth.

Conventional surgical procedures present additional problems when the patient in the chair has diabetes. The inevitable bleeding and inflammation during planning and work around the roots of teeth take so much more time and effort to control with diabetes on the plate.

Lasers are options worth considering for invasive periodontal procedures in diabetes. Injury and damage to surrounding tissues are considerably reduced by this highly focused method of intervention, helping people with diabetes recover from dental problems at about the same speeds as people with normal glucose metabolism.

Why are lasers not more widely used in surgical dentistry? The reasons lie in the technology of laser equipment for medical uses. A wide range of wave lengths and power factors are available, and a slight error in selecting equipment can do much harm to soft tissues inside the mouth.

Though conventional methods are your best bet if some surgical procedures are required in the mouth, and if you enjoy normal blood glucose levels, lasers are worth considering if you need extensive dental work and have diabetes at the same time. The trick is to locate someone with the right equipment and a sound track record in dealing with cases such as yours.

Ask your physician for a referral.

2-Step Simple Self-Care Solution to Stop Stones in Diabetes

I recently read a report which suggests that people with diabetes are more likely to develop kidney stones than other with normal glucose metabolism. (Let me know if your physician would like a link to this report).

There are many reasons why some people inherit a tendency to form kidney stones more easily than others. Urine analysis can suggest the most likely cause to a doctor.

Prescription medicines, lithotripsy, and various kinds of surgery, can be used to manage kidney stones, which are very painful indeed, but there are 2 easy things that you can do on your own to reduce the chances of stones forming:

1. Drink plenty of water: the chances are that crystals of calcium or oxalates will pass out before they can aggregate to any appreciable size. The actual quantity of water you need to drink a day varies with the climate and your level of physical activity, but 8 glasses is an average for the sub-tropical climate in which I live. Your doctor will be able to suggest a target which suits you best. Overall, it is quite possible that you drink less water than you should, so it always helps to review the matter.

2. Try and get your daily calcium requirements from diet, especially from unsweetened, low-fat milk, of from soy, or from coarse cereals, rather than from calcium tablets. The latter have become fashionable because of sustained advertising and promotion by manufacturers, but getting your calcium from the dietary sources I have mentioned is safer for your kidneys.

Let me know if you would like to know more, or if you would like to add your personal experiences with kidney stones, and their self-care methods for prevention.