Thursday 22 May 2014
Monday 2 April 2012
Khalid Riaz Visit to Higher Education Commission Islamabad
Untitled Album Slideshow: Khalid’s trip from Peshawar, Pakistan to Islamabad was created by TripAdvisor. See another Islamabad slideshow. Create your own stunning free slideshow from your travel photos.
Saturday 21 May 2011
Can Herbs Treat Diabetes?
Standard treatment for people with diabetes consists of careful meal planning, a regular exercise program, monitoring blood sugar levels and, when necessary, taking medications. By actively managing their disease and keeping blood sugar levels as close to normal as possible, people with diabetes not only feel better, they also help prevent the long-term complications, such as vision loss, heart attack, stroke, and kidney and nerve damage, that commonly develop when blood sugar levels are regularly too high.
Since there is no cure for diabetes, maintaining good health requires a lifelong commitment to blood sugar control--on-again, off-again efforts are not effective. The self-care requirements of diabetes, or any chronic disease, can be psychologically difficult to adjust to, and resisting the need to follow a regular, day-in and day-out, care plan is a common reaction. The result is that some people seek alternative treatments, if not outright "miracle cures," that seem easier or more "natural" and that allow them to avoid dealing with the realities of a chronic disease.
A so-called diabetes remedy that is gaining popularity today is herbal treatment, with a variety of plant-derived preparations being promoted as capable of controlling blood sugar levels. In fact, herbal treatment for diabetes is not new. Plants and plant extracts were used to combat the disease as early as 1550 B.C., with as many as 400 "prescribed" before the development earlier this century of effective medications to control diabetes. However, claims for the benefits of herbal treatments should be viewed with caution for several reasons.
Keep in mind that few of the herbs that reportedly lower blood sugar have been adequately studied to determine their actual effects. Although some of those that have been studied, often in animals rather than humans, do show a slight ability to lower blood sugar, their effects are not strong or predictable enough to adequately manage diabetes.
Of serious concern is the fact that herbal remedies are unregulated, and no preparation standards have been set for them. This means you can’t be sure the product you buy contains the ingredients its label promises in the amounts it promises, that its active ingredients are actually absorbed by the body or that it was manufactured safely and contains no harmful contaminants. The label may not mention known toxic effects, a particular problem since people often take excessive doses of herbal remedies believing that because they are "natural" they are also safe, so serious side effects can be a problem. Nor will there be information about how the herb may interact with other conventional medications a person may also be taking.
People who decide to try herbs may find they feel better, and therefore assume their diabetes is under control. Unfortunately, this is likely to be an illusion created by some preparations that produce a feeling of well-being without controlling excess sugar in the blood.
People considering, or already using, herbal or other alternative treatments for diabetes should discuss this interest with their physician, even if they fear looking silly or getting a lecture. A lot of progress in treating diabetes has been made since the time when nothing more effective than herbs was available. People with the disease do best when they work closely with their physician to be sure they gain the benefits of this knowledge.
Since there is no cure for diabetes, maintaining good health requires a lifelong commitment to blood sugar control--on-again, off-again efforts are not effective. The self-care requirements of diabetes, or any chronic disease, can be psychologically difficult to adjust to, and resisting the need to follow a regular, day-in and day-out, care plan is a common reaction. The result is that some people seek alternative treatments, if not outright "miracle cures," that seem easier or more "natural" and that allow them to avoid dealing with the realities of a chronic disease.
A so-called diabetes remedy that is gaining popularity today is herbal treatment, with a variety of plant-derived preparations being promoted as capable of controlling blood sugar levels. In fact, herbal treatment for diabetes is not new. Plants and plant extracts were used to combat the disease as early as 1550 B.C., with as many as 400 "prescribed" before the development earlier this century of effective medications to control diabetes. However, claims for the benefits of herbal treatments should be viewed with caution for several reasons.
Keep in mind that few of the herbs that reportedly lower blood sugar have been adequately studied to determine their actual effects. Although some of those that have been studied, often in animals rather than humans, do show a slight ability to lower blood sugar, their effects are not strong or predictable enough to adequately manage diabetes.
Of serious concern is the fact that herbal remedies are unregulated, and no preparation standards have been set for them. This means you can’t be sure the product you buy contains the ingredients its label promises in the amounts it promises, that its active ingredients are actually absorbed by the body or that it was manufactured safely and contains no harmful contaminants. The label may not mention known toxic effects, a particular problem since people often take excessive doses of herbal remedies believing that because they are "natural" they are also safe, so serious side effects can be a problem. Nor will there be information about how the herb may interact with other conventional medications a person may also be taking.
People who decide to try herbs may find they feel better, and therefore assume their diabetes is under control. Unfortunately, this is likely to be an illusion created by some preparations that produce a feeling of well-being without controlling excess sugar in the blood.
People considering, or already using, herbal or other alternative treatments for diabetes should discuss this interest with their physician, even if they fear looking silly or getting a lecture. A lot of progress in treating diabetes has been made since the time when nothing more effective than herbs was available. People with the disease do best when they work closely with their physician to be sure they gain the benefits of this knowledge.
The "Diabetic" Diet
Popular misconceptions about nutrition and diabetes include the idea that a "diabetic diet" is a "sugar free diet"; or that refined sugar is "bad" and "natural sweeteners" are "good". Can "non-sugar" foods be eaten in any amounts? Can a person with diabetes "cheat" every once in a while? What IS a "diabetic diet"? Because so many questions and misunderstandings exist, it is important for a person with diabetes to be able to understand the fundamentals of nutrition, one of several essential elements of successful diabetes management.
There is actually no such thing as a single "diabetic diet". The diet that a person with diabetes follows to help manage his or her blood sugar levels is based on the same nutrition principles that any healthy person, with or without diabetes, should follow for good health. When a person with diabetes sees a Registered Dietitian for nutrition counseling, the goal is to create a nutrition plan. This will help the person manage his or her blood sugar levels, reduce the risk of heart disease and other diet-related conditions, maintain a healthy weight, as well as meet the person’s nutritional, lifestyle, social, and cultural needs.
The energy that we get from foods, measured in calories, comes from three types of nutrients: fats, proteins, and carbohydrates. Any food that provides calories will raise blood sugar. When foods are digested, they are broken down into the body’s basic fuel-- glucose, a type of sugar. The glucose is absorbed by the bloodstream, and is then known as blood glucose or blood sugar. In a person without diabetes, insulin is released by the pancreas after a meal or snack to allow the glucose in the blood to get into the body’s cells, where it is burned for energy. This brings the level of glucose in the blood back down to the normal range. If insulin is not produced or is not working properly, the glucose can not enter the cells to be used, and it builds up in the bloodstream. This results in high blood sugar, and this condition is known as diabetes.
Although all foods that provide calories are converted into glucose by the body, certain nutrients have a more direct effect on the blood’s glucose level. Fats in foods are eventually digested and converted into glucose, but this can take up to 6 to 8 or more hours after a meal, and the release of glucose into the blood is v e r y s l o w ... Protein in foods (such as meats, poultry, fish, eggs, soy and other beans, and milk) takes about 3 to 4 hours after a meal to "show up" as blood glucose.
Carbohydrates, on the other hand, take only about half an hour to an hour after a meal to be turned into blood glucose. The word "carbohydrate" actually means "sugars and starches." Chemically, a starchy food is just a "chain" of glucose molecules. In fact, if a starchy food like a soda cracker is held in the mouth for a few minutes, it will start to taste sweet as the digestive enzymes in the saliva begin to break the starch down into its glucose parts.
Any food that is high in any type of carbohydrate will raise blood glucose levels soon after a meal. Whether a food contains one ounce of sugar (natural or refined) or one ounce of starch, it will raise blood glucose the same amount, because the total amount of CARBOHYDRATE is the same. Although a glass of fruit juice and the same amount of sugary soda may seem like a "good" versus "bad" choice, each will raise blood glucose about the same amount. This information regarding the amount of carbohydrate in different foods is the center of a nutrition management tool for people with diabetes called Carbohydrate Counting. Foods high in carbohydrates include starches such as rice, pasta, breads, cereals, and similar foods; fruits and juices; vegetables; milk and milk products; and anything made with added sugars, such as candies, cookies, cakes, and pies.
The goal of a diabetes nutrition plan is to provide a mixture of fats, carbohydrates, and proteins at each meal at an appropriate calorie level to both provide essential nutrients as well as create an even release of glucose into the blood from meal to meal and from day to day. A Registered Dietitian assesses the nutritional needs of a person with diabetes and calculates the amounts of fat, protein, carbohydrate, and total calories needed per day, and then converts this information into recommendations for amounts and types of foods to include in the daily diet. The total number of meals and snacks and their timing throughout the day can differ for each person, based on his or her nutritional needs, lifestyle, and the action and timing of medications.
Overall, a nutrition plan for a person with diabetes includes 10 to 20 percent of calories from protein, no more than 30 percent of calories from fats (with no more than 10 percent from saturated fats), and the remaining 50 to 60 percent from carbohydrates. Carbohydrate foods that contain dietary fiber are encouraged, as a high fiber diet has been associated with decreased risks of colon and other cancers. For people with high blood cholesterol levels, lower total fat and saturated fat contents may be recommended. Sodium intake of no more than 3000 mg per day is suggested; for people with high blood pressure, sodium should be limited to 2400 mg per day or as advised by a physician.
One "diabetic diet" definitely does not fit all. In fact, ANY food can fit into the diet of someone with diabetes, with the help and guidance of a Registered Dietitian. Managing blood glucose levels does not have to mean giving up favorite foods, sweets, or restaurants and fast foods. Each person with diabetes has very different nutritional and personal needs, making ongoing assessment and counseling with a Registered Dietitian an essential element of successful diabetes management.
There is actually no such thing as a single "diabetic diet". The diet that a person with diabetes follows to help manage his or her blood sugar levels is based on the same nutrition principles that any healthy person, with or without diabetes, should follow for good health. When a person with diabetes sees a Registered Dietitian for nutrition counseling, the goal is to create a nutrition plan. This will help the person manage his or her blood sugar levels, reduce the risk of heart disease and other diet-related conditions, maintain a healthy weight, as well as meet the person’s nutritional, lifestyle, social, and cultural needs.
The energy that we get from foods, measured in calories, comes from three types of nutrients: fats, proteins, and carbohydrates. Any food that provides calories will raise blood sugar. When foods are digested, they are broken down into the body’s basic fuel-- glucose, a type of sugar. The glucose is absorbed by the bloodstream, and is then known as blood glucose or blood sugar. In a person without diabetes, insulin is released by the pancreas after a meal or snack to allow the glucose in the blood to get into the body’s cells, where it is burned for energy. This brings the level of glucose in the blood back down to the normal range. If insulin is not produced or is not working properly, the glucose can not enter the cells to be used, and it builds up in the bloodstream. This results in high blood sugar, and this condition is known as diabetes.
Although all foods that provide calories are converted into glucose by the body, certain nutrients have a more direct effect on the blood’s glucose level. Fats in foods are eventually digested and converted into glucose, but this can take up to 6 to 8 or more hours after a meal, and the release of glucose into the blood is v e r y s l o w ... Protein in foods (such as meats, poultry, fish, eggs, soy and other beans, and milk) takes about 3 to 4 hours after a meal to "show up" as blood glucose.
Carbohydrates, on the other hand, take only about half an hour to an hour after a meal to be turned into blood glucose. The word "carbohydrate" actually means "sugars and starches." Chemically, a starchy food is just a "chain" of glucose molecules. In fact, if a starchy food like a soda cracker is held in the mouth for a few minutes, it will start to taste sweet as the digestive enzymes in the saliva begin to break the starch down into its glucose parts.
Any food that is high in any type of carbohydrate will raise blood glucose levels soon after a meal. Whether a food contains one ounce of sugar (natural or refined) or one ounce of starch, it will raise blood glucose the same amount, because the total amount of CARBOHYDRATE is the same. Although a glass of fruit juice and the same amount of sugary soda may seem like a "good" versus "bad" choice, each will raise blood glucose about the same amount. This information regarding the amount of carbohydrate in different foods is the center of a nutrition management tool for people with diabetes called Carbohydrate Counting. Foods high in carbohydrates include starches such as rice, pasta, breads, cereals, and similar foods; fruits and juices; vegetables; milk and milk products; and anything made with added sugars, such as candies, cookies, cakes, and pies.
The goal of a diabetes nutrition plan is to provide a mixture of fats, carbohydrates, and proteins at each meal at an appropriate calorie level to both provide essential nutrients as well as create an even release of glucose into the blood from meal to meal and from day to day. A Registered Dietitian assesses the nutritional needs of a person with diabetes and calculates the amounts of fat, protein, carbohydrate, and total calories needed per day, and then converts this information into recommendations for amounts and types of foods to include in the daily diet. The total number of meals and snacks and their timing throughout the day can differ for each person, based on his or her nutritional needs, lifestyle, and the action and timing of medications.
Overall, a nutrition plan for a person with diabetes includes 10 to 20 percent of calories from protein, no more than 30 percent of calories from fats (with no more than 10 percent from saturated fats), and the remaining 50 to 60 percent from carbohydrates. Carbohydrate foods that contain dietary fiber are encouraged, as a high fiber diet has been associated with decreased risks of colon and other cancers. For people with high blood cholesterol levels, lower total fat and saturated fat contents may be recommended. Sodium intake of no more than 3000 mg per day is suggested; for people with high blood pressure, sodium should be limited to 2400 mg per day or as advised by a physician.
One "diabetic diet" definitely does not fit all. In fact, ANY food can fit into the diet of someone with diabetes, with the help and guidance of a Registered Dietitian. Managing blood glucose levels does not have to mean giving up favorite foods, sweets, or restaurants and fast foods. Each person with diabetes has very different nutritional and personal needs, making ongoing assessment and counseling with a Registered Dietitian an essential element of successful diabetes management.
Carbohydrate Counting
Carbohydrate counting is one of several methods of meal planning used by people with diabetes. This relatively new approach was one of the meal planning methods used in the Diabetes Control and Complications Trial (DCCT), and it is based on recent advances in the study of diabetes management.
Carbohydrates in the diet have a direct effect on blood glucose levels. All foods that provide calories are converted into glucose by the body. While fats and proteins in a meal are eventually converted by the body into glucose to use for energy, carbohydrates (sugars and starches) are converted to blood glucose quickly- within an hour or so after a meal. Therefore, the level of glucose in the blood after a meal will be directly related to the amount of carbohydrate just eaten.
With the help of a Registered Dietitian, a person with diabetes can determine the amount of carbohydrate that should be eaten per day and at each meal and snack. The total amount of carbohydrate needed daily is based on a person’s calorie needs- carbohydrate should comprise 50 to 60 percent of the day’s calorie intake. For consistent blood glucose levels, the amount of carbohydrate eaten should be spread throughout the day; this will allow for a relatively even release of glucose into the blood from meal to meal and from day to day. For example, a person who needs about 1800 calories a day would need about 225 to 270 grams of carbohydrate a day, distributed evenly among the person’s meals and snacks. The total number of meals and snacks and their timing throughout the day can differ for each person, based on his or her nutritional needs, lifestyle, and the action and timing of medications.
According to recent research, the amount of carbohydrate in a meal is more important than the type of carbohydrate. Foods high in carbohydrates include starches such as rice, pasta, breads, cereals, and similar foods; fruits and juices; vegetables; milk and milk products; and anything made with added sugars, such as candies, cookies, cakes, and pies. Although a glass of fruit juice and the same amount of sugary soda may seem like a "good" versus "bad" choice, each will raise blood glucose about the same amount, because the total amount of CARBOHYDRATE is the same.
Contrary to the "old" philosophy of diabetes management in which sweets were "not allowed", refined sugars such as sucrose can be included in the diet of a person with diabetes, provided that the total carbohydrate content of that meal or snack remains the same. To use the carbohydrate counting method, then, it is very important to know your carbohydrate goal (the number of grams of carbohydrate to eat) for each meal and snack, as well as the carbohydrate content of different foods. Determining the amount of carbohydrate in foods can be done in several ways. The Nutrition Facts labels on packaged foods are very helpful: just look for the Total Carbohydrates line, which will give the carbohydrate content in grams per serving. Be sure to note the serving size listed on the label, as the nutrition information refers to one serving of that food. For people with diabetes who are familiar with the foods and serving sizes in the Exchange Lists for Meal Planning system, the conversion to carbohydrate counting is simple- each Starch, Fruit, and Milk exchange serving contains roughly 15 grams of carbohydrate. The carbohydrate content of foods can also be found in various reference books and charts available in the Nutrition or Food sections of most book stores.
A word of caution: while counting carbohydrates can help manage blood glucose levels, it can also lead to weight gain if the fat and protein contents of foods are ignored. A lot of foods contain both carbohydrate and fat, such as many desserts, which will dramatically increase the calorie content of your food choices and could lead to added pounds. A medium banana and a chocolate candy bar both contain about 30 grams of carbohydrate, but the chocolate bar also contains an extra 15 grams of fat and 150 calories!
For more information on carbohydrate counting and meal planning for people with diabetes, see a Registered Dietitian.
Carbohydrates in the diet have a direct effect on blood glucose levels. All foods that provide calories are converted into glucose by the body. While fats and proteins in a meal are eventually converted by the body into glucose to use for energy, carbohydrates (sugars and starches) are converted to blood glucose quickly- within an hour or so after a meal. Therefore, the level of glucose in the blood after a meal will be directly related to the amount of carbohydrate just eaten.
With the help of a Registered Dietitian, a person with diabetes can determine the amount of carbohydrate that should be eaten per day and at each meal and snack. The total amount of carbohydrate needed daily is based on a person’s calorie needs- carbohydrate should comprise 50 to 60 percent of the day’s calorie intake. For consistent blood glucose levels, the amount of carbohydrate eaten should be spread throughout the day; this will allow for a relatively even release of glucose into the blood from meal to meal and from day to day. For example, a person who needs about 1800 calories a day would need about 225 to 270 grams of carbohydrate a day, distributed evenly among the person’s meals and snacks. The total number of meals and snacks and their timing throughout the day can differ for each person, based on his or her nutritional needs, lifestyle, and the action and timing of medications.
According to recent research, the amount of carbohydrate in a meal is more important than the type of carbohydrate. Foods high in carbohydrates include starches such as rice, pasta, breads, cereals, and similar foods; fruits and juices; vegetables; milk and milk products; and anything made with added sugars, such as candies, cookies, cakes, and pies. Although a glass of fruit juice and the same amount of sugary soda may seem like a "good" versus "bad" choice, each will raise blood glucose about the same amount, because the total amount of CARBOHYDRATE is the same.
Contrary to the "old" philosophy of diabetes management in which sweets were "not allowed", refined sugars such as sucrose can be included in the diet of a person with diabetes, provided that the total carbohydrate content of that meal or snack remains the same. To use the carbohydrate counting method, then, it is very important to know your carbohydrate goal (the number of grams of carbohydrate to eat) for each meal and snack, as well as the carbohydrate content of different foods. Determining the amount of carbohydrate in foods can be done in several ways. The Nutrition Facts labels on packaged foods are very helpful: just look for the Total Carbohydrates line, which will give the carbohydrate content in grams per serving. Be sure to note the serving size listed on the label, as the nutrition information refers to one serving of that food. For people with diabetes who are familiar with the foods and serving sizes in the Exchange Lists for Meal Planning system, the conversion to carbohydrate counting is simple- each Starch, Fruit, and Milk exchange serving contains roughly 15 grams of carbohydrate. The carbohydrate content of foods can also be found in various reference books and charts available in the Nutrition or Food sections of most book stores.
A word of caution: while counting carbohydrates can help manage blood glucose levels, it can also lead to weight gain if the fat and protein contents of foods are ignored. A lot of foods contain both carbohydrate and fat, such as many desserts, which will dramatically increase the calorie content of your food choices and could lead to added pounds. A medium banana and a chocolate candy bar both contain about 30 grams of carbohydrate, but the chocolate bar also contains an extra 15 grams of fat and 150 calories!
For more information on carbohydrate counting and meal planning for people with diabetes, see a Registered Dietitian.
Restaurants, Fast Foods, and Good Nutrition
Kendra Blanchette, RD, CDE
According to the National Restaurant Association, Americans spent 44 percent of their food dollars outside the home in 1996. For many people, fast foods are a daily staple. Although eating out can pose a challenge to good nutrition, it is possible to include fast foods and restaurant meals in a healthful diet- even for people with diabetes. The key to following a diabetes meal plan away from home is to learn how to translate "menu language" into useful information for making smart food choices.For example, foods described as fried, creamed, au gratin, and sautéed are going to be high in fat. The same goes for foods prepared or served with a lot of cheese, butter, cream, oil, or mayonnaise. Condiments such as salad dressings and tartar sauce should be used in small amounts- ordering them "on the side" is a good idea to help control the amount actually eaten. Other words to look for that signal "high fat" are:
Hollandaise, Mornay, Béchamel, or Bernaise sauce
Gravy, roux, ghee Tempura
Scaloppini, parmigiana, alfredo, carbonara
Romanov, stroganoff
Scalloped
Buttery, flaky, crispy, rich
Croissant, pastry, pie, turnover
Chowder
The amount of fat in a restaurant or fast food meal can be greatly reduced by making even small changes. Just by ordering a hamburger without cheese, 55 calories and 5 grams of fat can be saved. "Hold the mayo", and save another 100 calories and 10 grams of fat! Ordering a salad or a clear soup with a meal in place of french fries or another high fat side dish is also a way to avoid extra fat.People with diabetes also need to be aware of the carbohydrate content of foods when planning a meal. Added sugars in foods can contribute significantly to a meal’s total carbohydrate content, so they can not be overlooked when making food selections. While desserts and regular sodas are obviously high in sugar, be aware that foods prepared with sweet and sour, teriyaki, barbecue (BBQ), and similar sauces likely will be high carbohydrate choices as well.
At most fast food restaurants, a chart or pamphlet outlining the nutritional content of menu items is available upon request. In addition, as of May 2, 1997, all eating establishments have to follow requirements for nutrition and health claims on menu items such as "Heart Healthy" or "Light", and give customers the nutrition information for these items when requested. Claims on a menu that promote a nutrition or health benefit must meet certain criteria established by the Food and Drug Administration (FDA) and the U.S. Department of Agriculture. For example, a restaurant meal that contains 26 grams of fat (40 percent of the Daily Value for fat) can not be labeled "Heart Healthy" on the menu. These claims therefore can be very helpful when making food choices consistent with a diabetes meal plan.
Overall, fast food and other restaurants offer many different choices. Following a diabetes meal plan while dining out requires knowledge of the principles of good nutrition, as well as an understanding of food vocabulary and menu descriptors. Learn as much as possible about foods and frequented restaurants: by making smart choices, any food can fit into a healthful diet.
Insulin
Since people with type I diabetes do not make insulin, which is necessary to maintain life, they must take insulin shots every day. Insulin cannot be taken in pill form. Some people with type II diabetes, who make insulin but can't use it effectively, may also be helped by taking insulin.
The goal of insulin treatment is to keep blood sugar as close to normal levels as possible throughout the day. So the amount of insulin needed and the number of times per day it is taken will vary according to each person's unique needs. Some of the factors that determine the amount and timing of insulin doses are body weight and build, level of physical activity, daily food intake, other medications being taken, general health and emotional state. Most people need at least two insulin shots per day, and some need more than one kind of insulin.
When a person first begins taking insulin, schedule and/or dose changes are made until optimal blood sugar control is achieved. So it is important for a person with diabetes to keep in regular touch with his or her doctor.
Each insulin box is marked with an expiration date, which should be checked before purchase. Always be sure to check not only the expiration date but the species, brand name, type and concentration of the insulin to be sure you are getting what your doctor has prescribed. And be sure you will use the entire bottle of insulin before it expires. Using the wrong insulin, or using insulin that has passed its expiration date, can affect your diabetes control.
The syringes used for your insulin injections must match the concentration of the insulin. If you use U-100 insulin, use syringes that have orange tops and that come in packages marked U-100. Be sure you buy syringes that hold your full dose of insulin.
Regular insulin should be clear, with no color, cloudiness or thickening. All other insulins should have an even, cloudy appearance after gentle shaking, like skim milk. They should have no insulin at the bottom of the bottle, no clumps in the liquid or on the bottom and no solid particles that give the bottle a frosty look.
Make sure to look at insulin carefully before using it-if it doesn't look right, it may not work correctly.
Store the insulin bottle you are using, as well as extra bottles, in the refrigerator; do not allow them to freeze. Insulin should not be shaken hard or tossed around.
Unrefrigerated insulin should be kept as cool as possible (below 86 degrees F) and away from heat and light. It should not be left in a parked car. When traveling by plane, keep your insulin and syringes in a carry-on bag to avoid having it get lost. (Insulin packed in bags that are checked may freeze in the cargo section of a plane, leading to loss of efficacy.
The insulin injected gets into your blood faster from some areas than from others, which can have an effect on your blood sugar. Talk to your doctor for more information about sites and about any adjustments you need to make for the various sites you are using.
Clean the rubber stopper on the top of the bottle with an alcohol swab. Then remove the cover from the needle and pull the plunger back to the line that indicates your dosage to pull air into the syringe. Holding the insulin bottle upright, push the needle through the rubber stopper until the tip is in the insulin, then press the plunger to push air into the bottle of insulin.
Turn the bottle and syringe upside down. Hold the bottle with one hand and use the other hand to pull back on the plunger to pull insulin into the syringe, filling it to the line that marks your dosage.
Check the syringe for any air bubbles. If there are bubbles, use the plunger to push the insulin back into the bottle, then slowly pull insulin into the syringe again, repeating until there are no large air bubbles in the syringe. Finally, double-check that your dose level is correct, then pull the needle out of the rubber stopper. If you must lay the syringe down before using it, be sure to cover it for protection. If the insulin is cold, you may want to warm it slightly by rolling the syringe gently between your palms.
Preparing your own mixed dose of insulin requires special instructions, which your doctor will give you if necessary.
Now you are ready to choose your injection site and clean it with an alcohol swab. Then pinch up a large area of skin and push the needle straight into it, ensuring that the needle is all the way in before you push the plunger all the way down. This pushes the insulin into your body.
Pull the needle straight out. Do not rub the injection site.
Safely dispose of your used needles and syringes. Your doctor or pharmacist can offer suggestions for environmentally safe disposal.
If you experience any dents, redness or swelling at your injection sites, or groups of small bumps, similar to hives, check with your doctor:
The goal of insulin treatment is to keep blood sugar as close to normal levels as possible throughout the day. So the amount of insulin needed and the number of times per day it is taken will vary according to each person's unique needs. Some of the factors that determine the amount and timing of insulin doses are body weight and build, level of physical activity, daily food intake, other medications being taken, general health and emotional state. Most people need at least two insulin shots per day, and some need more than one kind of insulin.
When a person first begins taking insulin, schedule and/or dose changes are made until optimal blood sugar control is achieved. So it is important for a person with diabetes to keep in regular touch with his or her doctor.
Insulin Types
Different types of insulin have different action times, or length of time they take to begin acting and length of time their effect lasts. Since people don't all respond the same way to these different types of insulin, people with diabetes must work with their doctor to find the type or types that work best for them.- Ultra Short-Acting Insulin: HUMALOG
- Short-Acting Insulin: Regular (R) and Semilente (r) (S). These preparations start and stop working more quickly than other types of insulin.
- Intermediate-Acting Insulin: NPH (N) and Lente(r) (L). These insulins take longer to start working and work longer than short-acting insulins.
- Long-Acting Insulin: Ultralente(r) (U). This insulin starts acting slowly and last the longest.
- Combination Insulins: 70/30 insulin contains 70 percent NPH and 30 percent Regular insulin, so the Regular begins working quickly, and the NPH takes over when the Regular is stopping. 50/50 insulin has equal parts of the two preparations.
Insulin Purchasing and Care
All insulin bottles sold in the U.S. have orange caps and are marked "U-100," which is referred to as its concentration. They contain 10 milliliters of fluid, with 100 units of insulin in each milliliter, for a total of 1,000 units of insulin per bottle. (U-40 insulin bottles, with red caps, are found in some countries outside the U.S., and U-500 insulin is available by prescription.)Each insulin box is marked with an expiration date, which should be checked before purchase. Always be sure to check not only the expiration date but the species, brand name, type and concentration of the insulin to be sure you are getting what your doctor has prescribed. And be sure you will use the entire bottle of insulin before it expires. Using the wrong insulin, or using insulin that has passed its expiration date, can affect your diabetes control.
The syringes used for your insulin injections must match the concentration of the insulin. If you use U-100 insulin, use syringes that have orange tops and that come in packages marked U-100. Be sure you buy syringes that hold your full dose of insulin.
Regular insulin should be clear, with no color, cloudiness or thickening. All other insulins should have an even, cloudy appearance after gentle shaking, like skim milk. They should have no insulin at the bottom of the bottle, no clumps in the liquid or on the bottom and no solid particles that give the bottle a frosty look.
Make sure to look at insulin carefully before using it-if it doesn't look right, it may not work correctly.
Store the insulin bottle you are using, as well as extra bottles, in the refrigerator; do not allow them to freeze. Insulin should not be shaken hard or tossed around.
Unrefrigerated insulin should be kept as cool as possible (below 86 degrees F) and away from heat and light. It should not be left in a parked car. When traveling by plane, keep your insulin and syringes in a carry-on bag to avoid having it get lost. (Insulin packed in bags that are checked may freeze in the cargo section of a plane, leading to loss of efficacy.
Insulin Injection Sites
Insulin injections can be given in a variety of sites on your body, including your thighs, upper arms, buttocks and abdominal area. Within each of these areas, there are many sites that can be used.The insulin injected gets into your blood faster from some areas than from others, which can have an effect on your blood sugar. Talk to your doctor for more information about sites and about any adjustments you need to make for the various sites you are using.
Preparing and Injecting Insulin
Always begin your preparation by washing your hands. To prepare a single insulin dose, gently mix the insulin by rolling the bottle between your palms, turning it over end to end a few times or gently shaking it. If you are using a new bottle, remove the flat colored cap, but not the rubber stopper or metal band under the cap.Clean the rubber stopper on the top of the bottle with an alcohol swab. Then remove the cover from the needle and pull the plunger back to the line that indicates your dosage to pull air into the syringe. Holding the insulin bottle upright, push the needle through the rubber stopper until the tip is in the insulin, then press the plunger to push air into the bottle of insulin.
Turn the bottle and syringe upside down. Hold the bottle with one hand and use the other hand to pull back on the plunger to pull insulin into the syringe, filling it to the line that marks your dosage.
Check the syringe for any air bubbles. If there are bubbles, use the plunger to push the insulin back into the bottle, then slowly pull insulin into the syringe again, repeating until there are no large air bubbles in the syringe. Finally, double-check that your dose level is correct, then pull the needle out of the rubber stopper. If you must lay the syringe down before using it, be sure to cover it for protection. If the insulin is cold, you may want to warm it slightly by rolling the syringe gently between your palms.
Preparing your own mixed dose of insulin requires special instructions, which your doctor will give you if necessary.
Now you are ready to choose your injection site and clean it with an alcohol swab. Then pinch up a large area of skin and push the needle straight into it, ensuring that the needle is all the way in before you push the plunger all the way down. This pushes the insulin into your body.
Pull the needle straight out. Do not rub the injection site.
Safely dispose of your used needles and syringes. Your doctor or pharmacist can offer suggestions for environmentally safe disposal.
Allergic Reactions
All insulins have added ingredients to prevent spoilage and to prevent bacteria from forming, and, in some insulins, to prolong their action times. Sometimes, people can develop allergic reactions to these ingredients.If you experience any dents, redness or swelling at your injection sites, or groups of small bumps, similar to hives, check with your doctor:
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