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Blood sugar balancing act

You've probably been hearing about blood sugar or blood glucose nonstop since your child was diagnosed with type 1 diabetes. That's because that's what type 1 diabetes does—it restricts the body from getting the sugar from food into the cells for energy. That's why your child has to take insulin, be smart about what they eat, and stay physically active to help keep their blood sugar within the target range recommended by their healthcare provider.

Keeping the balance

There are several things that have to be coordinated when it comes to keeping your child's blood sugar within the range set by his or her healthcare team:

  • What your child eats
  • How much your child eats
  • When your child eats
  • How active your child is
  • Your child's insulin schedule

Keep in mind that your child's insulin dose(s) may need to change because of illness, stress, other medicines they take, change in diet, or change in physical activity or exercise.

Matching the amount of Humalog® mealtime insulin with the amount of carbohydrates eaten is essential to maximizing blood sugar management. A dietitian, diabetes educator, or other member of your child's healthcare team can help you determine how to do this for your child. It is important to know that low blood sugar is the most common side effect of insulins, including Humalog. Humalog has not been studied in children under 3 years of age or in children with type 2 diabetes.

What blood sugar levels tell you and the healthcare team

Blood sugar testing shows how much sugar is in the blood at a given time. You've probably already heard why it's important to check your child's blood sugar. Keeping track of these levels will help you and your child's healthcare team:

  • Know whether your child is meeting their blood sugar goals
  • Learn how different foods and physical activities affect your child's blood sugar
  • Figure out how much insulin your child should be taking

These guidelines don't apply to everyone, so work with your child's doctor to set the right goals for your child.

Record your child's blood sugar levels in a logbook or journal and share the results with your child's healthcare team at each visit. If you see your child's blood sugar levels are too high or too low at certain times every day, your child's healthcare team can work with you to adjust his or her type 1 diabetes treatment plan.

Checking blood sugar

Be sure to talk to your child's healthcare team about when and how often you should check their blood sugar. Write down this testing schedule so you won't forget it. The exact timing of the checks depends on several factors, including your child's activities, when they eat, and how much they eat. Some instances when you'll want to check more often include when a child is sick, when there's a schedule change, or if there's been a change in treatment. By checking blood sugar (glucose) levels more frequently, insulin doses can be adjusted as recommended by your child's healthcare team to help keep your child's blood sugar in their target range.

Using a blood glucose meter

Blood glucose meters are small computerized devices that "read" blood sugar levels. The blood sugar level shows up as a number on a screen. A member of your child's healthcare team should also show you how to use a blood glucose meter to check your child's blood sugar levels.

Some tips on how to check blood sugar levels

  1. Wash and dry your hands.
  2. Choose a spot and, using a different finger each time, prick the side of the fingertip.
  3. Apply the blood droplet to a test strip and follow the manufacturer's directions that came with your child's glucose meter.
  4. Record the results.

A1C test

To see overall blood sugar management and to determine how well your child's type 1 diabetes treatment plan is working, your child's doctor will perform an A1C blood test approximately every 3 to 6 months. This test is an indication of your child's average blood sugar level over the last few months.

Blood sugar goals

For children with type 1 diabetes, the American Diabetes Association recommends the blood sugar goals seen in the chart below. These are guidelines only. Talk with your child's healthcare team to determine the right blood sugar goals for your child.

American Diabetes Association Recommended Blood Sugar Goals

Low blood sugar (hypoglycemia) is a possible side effect of Humalog that may be severe and cause unconsciousness (passing out), seizures, and death. Test blood sugar levels as your child's healthcare provider instructs.

  • Blood sugar balancing act
  • Low blood sugar
  • Treating severe lows
  • High blood sugar
  • Ins and outs of insulin
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©Lilly USA, LLC 2014.
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Not actual patients.

Important Safety Information for Humalog

What is the most important information I should know about Humalog?

  • Do not change the insulin you use without talking to your healthcare provider. Doses of oral antidiabetic medicines may also need to change if your insulin is changed.
  • Test your blood sugar levels as your healthcare provider instructs.
  • When used in a pump, do not mix Humalog with any other insulin or liquid.

Who should not take Humalog?

  • Do not take Humalog if your blood sugar is too low (hypoglycemia) or if you are allergic to insulin lispro or any of the ingredients in Humalog.

Before using Humalog, what should I tell my healthcare providers?

Tell your healthcare providers:

  • About all of your medical conditions, including liver, kidney, or heart problems.
  • If you are pregnant or breastfeeding.
  • About all the medicines you take, including prescription (especially ones commonly called TZDs [thiazolidinediones]) and non-prescription medicines, vitamins, and herbal supplements.

How should I use Humalog?

  • Humalog is a rapid-acting insulin. Take Humalog within fifteen minutes before eating or right after eating a meal.
  • Always make sure you receive the correct type of Humalog from the pharmacy.
  • Do not use Humalog if it is cloudy, colored, or has solid particles or clumps in it.
  • Do not mix Humalog with insulin other than NPH when using a syringe. Do not mix or dilute Humalog when used in a pump.
  • Inject Humalog under your skin (subcutaneously). Never inject into a vein or muscle. Change (rotate) your injection site with each dose. Make sure you inject the correct insulin and dose.
  • Depending on the type of diabetes you have, you may need to take Humalog with a longer-acting insulin or with oral antidiabetic medicines.
  • If you forget to take your dose of Humalog, your blood sugar may go too high (hyperglycemia), which can lead to serious problems like loss of consciousness (passing out), coma, or even death.
  • Your insulin dose may need to change because of illness, stress, other medicines you take, change in diet, or change in physical activity or exercise.

What are the possible side effects of Humalog?

  • Low blood sugar is the most common side effect. There are many causes of low blood sugar, including taking too much Humalog. It is important to treat it quickly. You can treat mild to moderate low blood sugar by drinking or eating a quick source of sugar right away. If severe, low blood sugar can cause unconsciousness (passing out), seizures, and death. Symptoms may be different for each person. Be sure to talk to your healthcare provider about low blood sugar symptoms and treatment.
  • Severe life-threatening allergic reactions (whole-body reactions) can happen. Get medical help right away if you develop a rash over your whole body, have trouble breathing, have a fast heartbeat, or are sweating.
  • Reactions at the injection site (local allergic reaction) such as redness, swelling, and itching can happen. If you keep having skin reactions or they are serious, talk to your healthcare provider. Do not inject insulin into a skin area that is red, swollen, or itchy.
  • Skin may thicken or pit at the injection site (lipodystrophy). Do not inject insulin into skin with these types of changes.
  • Other side effects include low potassium in your blood (hypokalemia), and weight gain.
  • Serious side effects can include:
    • - swelling of your hands and feet
    • - heart failure when taking certain pills called thiazolidinediones or “TZDs” with Humalog. This may occur in some people even if they have not had heart problems before. Tell your healthcare provider if you have shortness of breath, swelling of your ankles or feet, or sudden weight gain, which may be symptoms of heart failure. Your healthcare provider may need to adjust or stop your treatment with TZDs or Humalog.
  • These are not all of the possible side effects. Ask your healthcare providers for more information or for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

How should I store Humalog?

  • Unopened Humalog should be stored in a refrigerator and can be used until the expiration date on the carton or label.
  • Humalog should be stored away from light and heat. Do not use insulin if it has been frozen.
  • Opened vials should be kept at room temperature or in a refrigerator. Opened cartridges or prefilled pens should be kept at room temperature.
  • Once opened, Humalog vials, prefilled pens, and cartridges should be thrown away after 28 days.

Humalog is available by prescription only.

For additional information, talk to your healthcare providers and please click to access Full Prescribing Information and Patient Prescribing Information.

Please see Instructions for Use that accompany your pen.

HI CON ISI 29MAR2013

Humalog® and Humalog® KwikPen are registered trademarks of Eli Lilly and Company and are available by prescription only.

Humalog® KwikPen is a registered trademark of Eli Lilly and Company and is available by prescription only.

HumaPen® LUXURA is a registered trademark of Eli Lilly and Company. HumaPen® LUXURA HD is available by prescription only.

D-Tron® and D-Tronplus® are registered trademarks of Roche Diagnostics GmbH.

Other product names mentioned herein are the trademarks of their respective owners.

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 1/2 adult dose (0.5 mg). For children, withdraw 1/2 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.

You are encouraged to report negative side effects of Prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

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.

For more safety information, please click to access Information for the User and Information for the Physician.

HI GLUC CON ISI 1NOV2013

The Glucagon design is a trademark of Eli Lilly and Company. Glucagon is available by prescription only.

Apple®, the Apple logo®, iPad®, iPhone®, and iPod touch® are trademarks of Apple Inc., registered in the U.S. and other countries. App StoreSM is a service mark of Apple Inc.

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