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Meal Planning

One way to know how to follow a nutrition plan is to first understand the nature of type 1 diabetes and how your child's body reacts. Type 1 diabetes happens when the pancreas can't make insulin. Insulin is a hormone that helps the body get the sugar from food into the cells for energy. With type 1 diabetes, the body can't use the sugar it needs for energy. This results in high blood sugar.

So what and how much your child eats, when your child eats, how active he or she is, and your child's insulin schedule all have to be coordinated. Ideally, these all work together to help keep blood sugar (glucose) levels within the target range set by his or her healthcare team. Keep in mind that your child's insulin dose may need to change because of illness, stress, other medicines they take, change in diet, or change in physical activity or exercise.

Carbohydrates and type 1 diabetes

Carbohydrates (carbs) have the most immediate effect on blood sugar levels and cause blood sugar to go up. Some people use a system of "carbohydrate counting" to help manage blood sugar. Talk with your child's doctor about how to adjust their insulin dose for meals with different amounts of carbohydrates.

One important thing to remember is that sweets aren't the only foods that can affect blood sugar—all carbohydrates in food (like grains, fruits, milk) are broken down and affect blood sugar. By teaching your child that foods and drinks with carbohydrates can raise their blood sugar levels, you will help them begin to understand how different foods affect their body.

Reading nutrition information

One of the ways to find out the carbohydrate count of a particular food is to check the amount of "Total Carbohydrates" located in the nutrition information panel on the packaging. Total carbohydrate lists the number of grams of fiber, sugars, and other carbohydrates in one serving of the particular food. While it might seem like you should check "grams of sugar," that number doesn't show everything that affects blood sugar levels and isn't the one to use.

One other thing to keep in mind when checking nutrition information is that fat can slow down the absorption of sugar by the body. The fat content of a meal can affect blood sugar several hours later. If you notice that certain foods usually boost your child's blood sugar levels more than others, keep that in mind when planning their meals and try to limit those foods.

Portion size matters

It's important to learn how to correctly measure the portion size of the food your child eats. This way, you'll be able to understand how many carbs they are getting in each meal. With packaged foods, you can check the top of the food label for serving size. The "Total Carbohydrates" farther down on the label shows the amount of carbohydrates in the food per serving size. Remember, the serving size on a label isn't always the same as how much your child eats or how much their healthcare team would recommend.

Estimating portion size

It's important for your child to eat the right amount, not just the right foods. Using measuring cups and spoons to determine portion sizes is recommended. In case these are not handy, the images below use some common items to help you estimate.

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How to plan a meal

You might be wondering whether your child with type 1 diabetes can still eat their favorite foods. The truth is that they can, but there are some things you can do to help make the meals healthier.

Here's an example of how to prepare a typical meal for your child. This example is a fairly common lunch—tomato soup with half a grilled cheese sandwich.

If you're using prepared tomato soup, check the nutrition information on the packaging. Take a look at how many grams of carbs there are per serving size. When making the grilled cheese sandwich, check the nutrition information of each ingredient—one slice of cheese, two pieces of bread, and teaspoon of margarine or butter (if used). If your child eats one serving size, add up the number of carbohydrates per serving size for each ingredient. If they eat more than one serving, add in the extra carbs.

If your child has a set carb goal at meals and a certain meal isn't in range, you can substitute one of the higher carbohydrate foods with another ingredient lower in carbs. For example, you could replace the white bread in the sandwich with one of the many light breads for sale in most grocery stores. These are just general guidelines. Discuss them with your child's healthcare team and adjust to meet your child's needs.

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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

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

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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

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