Problem No. 4: “I am on mealtime insulin Humalog and sometimes I get overworked and may not have time to eat lunch. Should I inject a lower dose?

Solution: As I mentioned in Part 1 of this article series, ideally it’s best consume three balanced meals and two snacks for best nutritive and glucose control outcome. But we all at times find ourselves struggling with our schedules and occasionally have to skip a meal. If you are on mealtime insulin such Humalog, Novolog or Apidra and are going to skip a meal — or not consume any carbs in a meal — then you need to skip the insulin dose for that meal. In the event that you have already administered the insulin dose and for whatever reason are unable to eat that meal, closely monitor your blood sugar and dissolve glucose wafers in your mouth until your blood sugar reads at 70 mg/dl or above.

Problem No. 5: “If I have a cold and don’t have an appetite, can I skip eating that day and skip taking my oral diabetes medications or insulin?”

Solution: This is definitely not the proper course of action. If you don’t have an appetite due to sickness, surgery or other trauma, get a six-pack of Glucerna shakes from the diabetic section of your local pharmacy and consume one bottle to replace a meal or a snack and continue your treatment as prescribed. Do this until you’re able to get your appetite back and are able to consume regular meals and snacks. Also, during trauma or cold your blood sugar may be out of control so monitor your blood sugar more often than regular days.

Problem No. 6: “I started exercising, but I’ve been not been feeling good and experiencing some bouts of nausea and dizziness.”

Solution: Of course exercising and physical activity is a great thing for anyone’s health — and is vital for people with diabetes and pre-diabetes to resolve insulin resistance, reduce belly fat and improve your sugar control. One of the fastest fuels for your working muscles is glucose. As you begin your bout of physical activity, your muscles start taking up the sugar from your blood to inside your muscle cells with the help of insulin. So the reason you’ve been experiencing nausea is because your blood sugar has been dropping lower than 70mg/ml and you’ve been experiencing hypoglycemia.

That’s why it is very important to test your blood sugar before and after physical activity to know where your sugar levels are. About an hour and half to two hours before you exercise, have a piece of fruit and some nuts. Then within 30 minutes after you exercise, consume a cup of pure fruit smoothie or juice to help with your muscles’ recovery process and replenish the nutrients and water you lost during exercise. Don’t forget to drink water before, during and after your workout.

Small Actions of the Week:

  1. If you can’t consume a meal or if a meal does not contain any carbs, skip your dose of meal-time insulin.
  2. In case of loss of appetite due to trauma, cold or sickness consume a Glucerna shake — which a specially formulated for people with diabetes — and continue your treatment as usual.
  3. Check your blood sugar more frequently during times of sickness and when becoming physically active.

Pharmacist George Tohme is author of Lifestyle Makeover for Diabetics and Pre-Diabetics

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