LESSON 8: USING MEDICINE SAFELY FOR MAXIMUM EFFECTIVENESS

LEARNING OBJECTIVES WE WILL DISCUSS… HOW DIFFERENT MEDICATIONS WORK TO HELP KEEP YOUR BLOOD SUGAR UNDER CONTROL AND WHICH TISSUES ARE AFFECTED BY DIABETES MEDICATIONS TIPS FOR TAKING DIABETES MEDICATIONS HOW TO INJECT INSULIN (IF NECESSARY) TIPS FOR INJECTING INSULIN IN PUBLIC SETTINGS

WHERE DIABETES MEDICATIONS WORK    Insulin Decreases blood sugar levels by directly signaling the liver, muscle and fat to uptake glucose from the blood; short‐acting insulins act immediately, and long‐term insulins act over the course of 12‐24 hours. Alpha-glucosidase inhibitors Slow the digestion of carbohydrates, helping keep blood sugar levels in the target range following a meal. Biguanides Decrease the production of glucose by the liver and increase insulin sensitivity in the muscle, liver and fat.  DPP-4 Inhibitors Increase insulin release by the pancreas.  Glinides Cause a small burst of insulin to be released following a meal; can cause hypoglycemia (low blood sugar).

  Sulfonylureas Help the pancreas produce and secrete more insulin; often effective for between 24‐72 hours. Thiazolidinediones (TZDs) Increase insulin sensitivity in muscle and fat cells; help reduce the production of glucose in the liver. SGLT2 Inhibitors Block the reabsorption of glucose in the kidney, increase glucose excretion GLP 1-Agonists Increase insulin secretion, decrease glucagon secretion, and delaying gastric emptying (incretin mimetic)

TIPS FOR TAKING DIABETES MEDICATIONS Continue taking diabetes medications even if you feel better; always check with doctor before change dose, time and/or frequency. Refill prescriptions before they run out; mail- order pharmacies can help manage prescriptions. Prepare a travel kit so that can take medications with you wherever you go. Call your doctor if notice unwanted side effects. Create a daily calendar that reminds you to take your medications at the proper time. Stay organized! THREE MAIN WAYS OF TAKING DIABETES MEDICATIONS: ORAL INJECTABLE ELECTRONIC DEVICES

UNDERSTANDING INSULIN INJECTIONS FOLLOW THESE STEPS EVERY TIME YOU INJECT INSULIN 1) Wash your hands with soap and water. 2) If you are using an insulin pen, put a new needle onto your pen; insulin syringes are for one time use only. 3) Determine the number of units that you need to inject; count the number of carbohydrates in your meal and divide the number of carbohydrates by your carbohydrate to insulin ratio. 4) Pinch 2-3” of skin between your thumb and index finger in a fatty area of your body (abdomen, buttocks, upper outer arms, upper outer thighs). 5) Inject the needle into the skinfold; when the needle is fully inserted, push the plunger and inject the insulin dose slowly. 6) After the injection, remove the needle and deposit into a sharps box containing medical waste.

TIPS FOR INJECTING INSULIN IN PUBLIC PLACES You might not always be at home when it comes time to inject insulin; often it is necessary that you inject when outside of your house, in a public setting or group social situation. CHOOSE TO INJECT IN A GROUP SETTING; TALK ABOUT IT OPENLY WITH PEOPLE THAT ASK. WHEN SITTING AT A TABLE, DISCRETELY INJECT INSULIN WHILE OTHERS ARE EATING. CHOOSE A PRIVATE LOCATION, SUCH AS A PUBLIC RESTROOM, YOUR CAR, OR A SPARE BEDROOM.