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.
Glucagon is a treatment for insulin coma or insulin reaction resulting from severe low blood sugar.
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 (hypoglycemia) has occurred.
For complete instructions on how to administer Glucagon, please click to access full Information for the User.
Be better prepared to treat severe low blood sugar with a Lilly Glucagon™ Emergency Kit.
Glucagon is a treatment for insulin coma or insulin reaction resulting from severe low blood sugar.
Important Safety Information for Glucagon
What is the most important information I should know about Glucagon?
- Glucagon should not be used if you have pheochromocytoma or if you are allergic to Glucagon.
- 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.
- You and anyone who may need to help you during an emergency 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 bottle label.
- 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 (HIGH BLOOD GLUCOSE) RATHER THAN HYPOGLYCEMIA. IN SUCH A CASE, YOU WILL NOT RESPOND TO GLUCAGON AND REQUIRE IMMEDIATE MEDICAL ATTENTION.
Who should not use Glucagon?
Glucagon should not be used if you have pheochromocytoma or if you are allergic to Glucagon.
What should I tell my doctor before taking Glucagon?
Tell your doctor about all of your medical conditions and prescription and over-the-counter drugs. Tell your doctor if you have been diagnosed with or have been suspected of having pheochromocytoma or an insulinoma.
How should I use 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 bottle immediately before giving 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 (1 unit). 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 bottle (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.
What is some important Information I should know about Low Blood Sugar (Hypoglycemia)?
- Early symptoms of low blood sugar include: sweating, drowsiness, dizziness, sleep disturbances, palpitation, anxiety, tremor, blurred vision, hunger, slurred speech, restlessness, depressed mood, tingling in the hands, feet, lips, or tongue, irritability, lightheadedness, abnormal behavior, inability to concentrate, unsteady movement, headache, and personality changes. These symptoms may be different for each person and can happen suddenly.
- If your low blood sugar is not treated, you may progress to severe low blood sugar that can include: disorientation, seizures, unconsciousness, and death.
- Low blood sugar symptoms should be treated with a quick source of sugar which should always be carried with you. If you do not improve or you are unable to take a quick source of sugar, you should be treated with Glucagon or with intravenous glucose at a medical facility.
What are the possible side effects of Glucagon?
- Severe side effects are very rare, although nausea and vomiting may occur occasionally.
- A few people may be allergic to Glucagon or to one of the inactive ingredients in Glucagon, or may experience rapid heart beat for a short while.
- If you experience any other reactions which are likely to have been caused by Glucagon, please contact your doctor.
How should I store Glucagon?
- Before dissolving Glucagon with diluting solution, store the kit at controlled room temperature between 20° to 25°C (68° to 77°F).
- After dissolving Glucagon with diluting solution, use 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 09OCT2014