Protecting Your Diabetes Supplies during the Summer Months

For many people, summertime means time at the pool, days at the beach, backyard barbecues, and outside fun with family and friends!  During the hot summer months, you want to make sure you protect your diabetes supplies and equipment.  Heat can have negative impacts on your oral medication, insulin, blood glucose meter, and test strips.  Let’s take a look at some tips to keep your diabetes supplies safe during the hot summer months!

Insulin

Insulin can become damaged and ineffective in extreme heat.  Be sure to keep insulin pens and insulin vials refrigerated. . If you don’t have access to a refrigerator, it is perfectly fine to carry these supplies with you during the day unrefrigerated, just as long as you’re careful to keep them out of direct sunlight, and in a cool environment.  On the other hand, never store insulin next to a frozen ice pack—freezing will ruin the insulin.  Be sure to look at the medication insert for specific information on temperature thresholds for your specific insulin.

Oral Medications

Heat can also harm the effectiveness of oral diabetes medications.  Most oral medications have a therapeutic temperature range above which they don’t work as well.  Look at the medication insert for specific information on heat thresholds for you oral diabetes medications.

Blood Glucose Meter

Your blood glucose meter plays an important role in caring for your diabetes, so you want to be sure to take good care of it.  That means you should never expose it to extreme temperatures, whether that may be freezing cold, or intense heat. During the hot summer months, you don’t want to keep your meter in your car since cars can get extremely hot.  Always keep it in a cool dry place.

Test Strips

Test strips are another important tool in caring for diabetes, and we know how costly they are too.  You need protect your investment and never expose test strips to heat, which can leave the test strips working incorrectly.  Never leave your strips exposed to extreme temperatures, and always close the cap on a canister of test strips. Keeping the lid closed at all times will protect the integrity of the strips, and also keep out moisture.

 

Whitney Roberts, RD, CDE

Fit4D CDE

Summer Travel & Diabetes

Summer is upon us, and for many people that means travel plans!  Diabetes shouldn’t hold anyone back from getting out and enjoying the fun!  The important thing to focus on, is taking your care routine with you.

 

The Essentials

Packing double the amount of medication and supplies you usually use is a great idea, incase of delays in traveling or other unexpected events.  Think about packing medication, test strips, lancets, batteries for your meter, and ketone strips.  Always take copies of prescriptions with you, should you need to get refills on the road.   Keep your health insurance card and emergency contacts in an easy to find place for emergencies; wear your medical ID bracelet or necklace.  If on insulin, be sure to bring a glucagon kit, as well as plenty of syringes or other insulin delivery devices.  It is also a good idea to check out where to get medical care near your travel destination as well.  Better to be prepared and not need it then want it and not have it.

Bring a note with you from your doctor explaining that you have diabetes and what medications you need.  If traveling to a location where a different language is spoken, consider having the note translated into the appropriate language(s).  Medications and other diabetic supplies should be packed in your carry on bag, rather than in checked luggage so that there is no risk of losing it.  Keep time zone changes in mind as you go, and be sure to take your medication at your usual times.

If you utilize an insulin pump, there are a few extra things to consider.  Request a private screening at the airport, rather than going through the body scanner.  Make sure you have extras of all your supplies – reservoirs, infusion sets, inserters if you need one, extra batteries for your pump, glucose tablets, non-perishable snacks and insulin.

 

Move!

With driving, or flying, there is always a risk of blood clots when you sit still for awhile.  Try to move around every hour or two if you are at risk for these.  Insulin that is open and in use, needs to be kept at room temperature.  If you will be in a hot car or other area, remember to pack your insulin with a cooling ice pack, putting a towel between the ice and medication to prevent it from accidentally freezing.  If you are in an area that will be excessively cold, keep your open insulin close to your body to keep it the appropriate temperature.   Unopened insulin should always be kept at refrigerator temperature, so this should be wrapped in a towel and placed with an ice pack as well.

 

Prepare for Lows

Pack plenty of pure sugar items that you can use in case of a low blood sugar.  Healthy snacks like fruit, raw veggies and bottled water are a good idea too as these are not always readily available on the road or in the air.  Make sure you have access to nutrition information.  If the places you will be eating at don’t have carbohydrate information readily available, download a nutrition database app such as Calorie King or Nutrition Data, or get a hard copy of their pocket guide versions.

Once you arrive at your travel destination, try to maintain your usual activity level to keep blood sugars in check.  And above all else, test your blood sugar!  Even more than usual, since changes in routine, eating and exercise habits can drastically affect blood sugar levels.  The more you check, the more chances you have to improve the results.  It can be difficult to balance your diabetes with changes in routine, but it if you plan ahead you can fully enjoy your summer vacation!

 

Gabrielle Kemble, RD, CDE

Fit4D CDE & Clinical Manager

 

5 Tips to Help Your Patients with Diabetes Stay on Track with Their Medication

Health care providers prescribe medications hundreds of times each week, but to a person newly diagnosed with Type 2 diabetes, hearing “I want you to take ____” is a public admission of failure. Failure to lose weight. Not making time for exercise. Inability to change habits like flavored coffee for breakfast or a favorite aunt’s cinnamon buns during family gatherings.

For many people with diabetes , a prescription for oral medication or even worse – insulin – is a sure signal that amputation, blindness, renal failure and death is just around the corner. Often too shocked, scared, or angry to ask questions, your patient leaves your office with prescription in hand but never fills it. Or they fill it, but decide they won’t take it because they hope to make the lifestyle changes that they’ve been putting off for months or years. Sometimes they fill the script but only take the medication when they remember, or when no one else is around so they don’t have to admit they have diabetes, or when they feel like their blood sugar is high.

Here are 5 important strategies we’ve found successful in empowering and motivating people with type 2 diabetes to take their meds as prescribed:
1. WIFM: What’s In It For Me. Explain why the medication is necessary both for short-term management of diabetes as well as prevention of long-term complications. Talk about how the med will address how the person feels on a daily basis, addressing any complaints they talked about during their examination.

2. Describe how the medication works in easily understandable language and provide clear, easy to understand written materials. Often newly diagnosed people with diabetes don’t know the difference between oral meds and insulin, or that oral meds work in a variety of ways. If you don’t provide written information, many people go home and do a Google search which may lead them to inaccurate information or promises of ‘natural’ cures.

3. Talk about possible side effects and how to minimize them. Ask what side effects they’ve heard about, or which ones concern them the most. Weight gain or inability to lose weight and fear of hypoglycemia are two of the most common fears.

4. Know the cost of the medication and if the insurance plan will cover it. People often don’t want to admit that they can’t afford a medication, and take it less often than prescribed or won’t refill the script.

5. Ask open-ended questions that show you are listening to their fears and that you’re working together to improve their health. Examples of questions to encourage an open discussion:
a. How will you manage taking this medication? What is your usual routine for taking medication and how will you add this med to your routine?
b. What have you heard from your family, friends or other people with diabetes about this medication?
c. What might get in the way of taking this med?

If you don’t have time to explain how the medication works and answer questions, assign this task to another member of your health care team. Tell your patient why you’re prescribing the medication and that you will have them meet with this professional to explain how to take the medication and answer all their questions.

We often label people with diabetes non-compliant when they don’t follow-through with prescribed medications. Non-compliance is like an onion: peel away the layers until you find the actual reason why your patient didn’t fill the script or ‘forgets’ to take the med. We can’t assume that people with diabetes take their meds as prescribed, and we also can’t assume that we know why they don’t take their medications. The only way to find out the truth is to have an open and honest discussion.

Written by:

Lynn Grieger, RD, CDE, CPT, CWC

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References:
Medication Adherence. Its Importance in Cardiovascular Outcomes. Ho PM, Bryson CL, Rumsfeld JS. Circulation. 2009; 119: 3028-3035.
Working With Patients to Enhance Medication Adherence. Lin EHB, Ciechanowski P. Clinical Diabetes January 2008 vol. 26 no. 1 17-19.