Managing Blood Sugar
What to expect
Everyone’s experience with mealtime insulin is different, but there are some things you can look out for.
Your Humalog dose will probably change over time. Your doctor gave you a starting dose, but most people need to increase their Humalog dose over time.
Blood sugar variations
When you track your blood sugar every day, you will probably see different numbers all the time. These variations in your blood sugar from day to day are normal.
Changes are normal
Your blood sugar varies based on stress, what you eat, other medications, exercise, and other factors. Don't be discouraged by changes in your blood sugar. With your doctor’s input, these variations may provide learning opportunities.
Testing your blood sugar
When using mealtime insulin like Humalog, you must test your blood sugar (glucose) regularly. For example, you may need to test before and after meals and at bedtime. Your doctor will tell you when and how often you should test.
Why keep track?
Keeping track of your blood sugar levels will help you and your doctor:
- Know if you’re meeting your blood sugar goals
- Learn how different foods affect your blood sugar levels
- Figure out how much insulin you should be taking
Your doctor will tell you what to do if your blood sugar is high or low. If you take too much Humalog, your blood sugar may fall too low (hypoglycemia). If you forget to take your dose of Humalog, your blood sugar may go too high (hyperglycemia).
Your blood sugar goals
The American Diabetes Association recommends blood sugar goals for people with diabetes. These don’t apply to everyone, however, so work with your doctor to set the right goals for you.
A1C (Tested by your doctor)
Less than 7%
These goals are not applicable to pregnant women or children. These goals should be individualized.
About high blood sugar
One of the goals of your diabetes treatment is to keep blood sugar levels within the target range determined by your doctor. When your blood sugar level is above the target range, this is called high blood sugar (hyperglycemia).
Possible causes of high blood sugar
Not taking diabetes medication, or taking too little, or timing it wrong
Eating too much or not eating the appropriate balance of food
Illness or infection
Trauma/stress—physical and/or emotional
What to do if you have high blood sugar
Adjust your insulin dose to bring the blood sugar levels back into your recommended range*
Drink extra water
Check for ketones in a blood or urine sample if your blood sugar levels are above 250 mg/dL†
These are guidelines only. Please discuss specific high blood sugar recommendations with your healthcare team.
*Your recommended range as directed by your healthcare team.
†Your healthcare team can provide more details on how to check for ketones.
How you might feel
High blood sugar can include any combination of these symptoms and/or others not listed.
About low blood sugar
Low blood sugar, also called hypoglycemia (70 mg/dL or below), is the most common side effect associated with insulins, including Humalog. It can be caused by:
- Being more physically active than usual
- Taking too much diabetes medication
- Eating at the wrong time for the medication you take
- Taking other medication in addition to Humalog
- Skipping or not finishing meals or snacks
Low blood sugar can also be caused by a combination of these or other factors.
What does low blood sugar feel like?
Managing low blood sugar
Low blood sugar is very serious, but it usually can be managed. Here are the American Diabetes Association recommendations for what to do immediately if you think you have low blood sugar:
- Check your blood sugar level. Remember, below 70 mg/dL is usually too low.
- If your blood sugar is too low, eat something with sugar right away (see below).
- After 15 minutes, check your blood sugar level again.
- Repeat treatment if necessary. If your blood sugar is still low after another 15 minutes, call your emergency service (911) or your doctor.
After you have treated your low blood sugar, be sure to eat regular meals and snacks.
How to quickly raise your blood sugar
Three good options for quickly raising low blood sugar levels include:
4-5 glucose tablets
15 small, sugary, chewable candies (such as jelly beans)
½ cup of fruit juice
Stick to these or similar options. A chocolate bar, for example, has fats and protein that prevent the sugar from being absorbed quickly.
These are guidelines only. These are examples of items that contain 15 grams of carbohydrates. Check food product labels to ensure that you are getting the right amount of carbohydrates. Please discuss recommendations specific to your low blood sugar with your doctor or nurse.
Low blood sugar (hypoglycemia) is the most common side effect of Humalog that may be severe and cause unconsciousness (passing out), seizures, and death. Test your blood sugar levels as your doctor instructs.
Remember that if low blood sugar is not treated quickly, it can become severe. And severe low blood sugar is very serious.
Treating severe low blood sugar with Glucagon
You’ll want to be ready in case you or someone close to you experiences severe low blood sugar. The possibility of severe low blood sugar can be scary. When a person’s blood sugar falls this low, loss of consciousness may occur and they may be physically unable to eat or drink a fast-acting source of sugar (glucose). They may need a Glucagon shot—and you, a family member, or another adult will need to be ready to give it to them.
Glucagon is a medicine that is different from insulin. It works by telling the body to release sugar (glucose) into the bloodstream to bring the blood sugar level back up.
Ask your doctor about prescribing more than one Glucagon kit. Your insurance plan may allow you to receive more than one kit with only one co-pay. And always be sure to check your kit’s expiration date.
Remember to call 911 immediately after giving a Glucagon injection and to notify your doctor that an episode of severe low blood sugar (severe hypoglycemia) has occurred.
For complete instructions on how to administer Glucagon, please click to access full Information for the User.
INDICATION: Glucagon is a treatment for very low blood sugar (severe hypoglycemia) which may occur in patients with diabetes. Symptoms include disorientation, unconsciousness, and seizures or convulsions.
Important Safety Information for Glucagon
What is the most important information I should know about Glucagon?
- You should NOT use Glucagon if you have a pheochromocytoma or if you are allergic to Glucagon. (A pheochromocytoma is a tumor, typically of the adrenal gland, that may lead to increased heart rate, blood pressure, sweating, and anxiety.)
- Make sure you tell your healthcare provider if you have been diagnosed with or have been suspected of having an insulinoma, as Glucagon should be used cautiously in this situation. (An insulinoma is a pancreatic tumor that secretes insulin.)
- You and anyone who may need to help you if your blood sugar becomes very low (severely hypoglycemic), should become familiar with how to use Glucagon before an emergency arises. Read the Information for the User provided in the kit.
- Make sure that your relatives or close friends know that if you become unconscious, medical assistance must always be sought. If you are unconscious, Glucagon can be given while awaiting medical assistance.
- Do not use the kit after the date stamped on the vial of Glucagon.
- If you have questions concerning the use of this product, consult a doctor, nurse, or pharmacist.
WARNING: YOU MAY BE IN A COMA FROM SEVERE HYPERGLYCEMIA (VERY HIGH BLOOD SUGAR) RATHER THAN HYPOGLYCEMIA (VERY LOW BLOOD SUGAR). IN SUCH A CASE, YOU WILL NOT RESPOND TO GLUCAGON AND REQUIRE IMMEDIATE MEDICAL ATTENTION.
What are the possible side effects of Glucagon?
- Side effects may include nausea and vomiting, a temporary increase in heart rate, and allergic reactions to Glucagon or to one of the inactive ingredients in Glucagon.
How should I take Glucagon?
- Act quickly. Prolonged unconsciousness may be harmful.
- Make sure your family and friends know to turn you on your side to prevent choking if you are unconscious.
- The contents of the syringe are inactive and must be mixed with the Glucagon in the accompanying vial immediately before giving the injection. Do not prepare Glucagon for Injection until you are ready to use it.
- Glucagon should not be used unless the solution is clear and of a water-like consistency.
- The usual adult dose is 1 mg. For children weighing less than 44 lbs (20 kg), give ½ adult dose (0.5 mg). For children, withdraw ½ of the solution from the vial (0.5 mg mark on syringe). Discard unused portion.
- You should eat as soon as you awaken and are able to swallow. Inform a doctor or emergency services immediately.
How should I store Glucagon?
- Store the kit at controlled room temperature between 20° to 25°C (68° to 77°F) before mixing Glucagon with the diluent.
- Glucagon that has been mixed with diluent should be used immediately. Discard any unused portion. Glucagon should be clear and of a water-like consistency at time of use.
Glucagon is available by prescription only.
HI GLUC CON ISI 18APR2018