The tips, hints and advice in this section are from real people living with diabetes. They have successfully included a mealtime insulin like Apidra® into their life. And they are all using it as an important part of their diabetes treatment plan for managing blood sugar levels. We hope this information will help you incorporate Apidra® into your diabetes management plan and be more successful managing your blood sugar levels.
Working Apidra® into your daily routine
Determining how much Apidra® insulin to take
Exercise and Apidra®
Eating out with Apidra® mealtime insulin
How to travel with Apidra®
Getting started on Apidra®
Working Apidra® into your daily routine
Tip #1:
I take a blood sugar test before each meal. I carry my meter with me wherever I
go. While this might seem like a lot to do, when you realize what you'll get out
of it, you just do it. After about a month, these things became habits. I don't
even think about them anymore.
Tip #2:
If I'm at home, I take Apidra® insulin just before I eat. If I'm at work,
I take it in my office and then go to lunch -- if I know where I'm going to eat
and how soon. I make sure that I expect to eat no longer than 15 minutes later.
If I'm not sure about when I'll eat, I bring my insulin with me and take it at the
restaurant.
Tip #3:
I learned as much as I could about carbohydrate counting. That made it easier for
me to figure out how to match my carbohydrate intake to my mealtime insulin intake.
Don't expect it to happen overnight. It was difficult for me and my healthcare provider
to figure out what ratio to use (insulin to carbohydrates) at each meal. That
was a great deal of trial and error. I wrote everything down in a journal about my food
intake and insulin dosing for months before my healthcare provider and I finally
arrived at an insulin to carbohydrate ratio (i.e. 1 unit of insulin to a number of
grams of carbohydrate consumed) that worked well for me. But now that I understand
it, I know that I can manage my blood sugar levels at mealtimes throughout the day.
Tip #4:
I bring my mealtime insulin with me wherever I go. When I am at home, I take my Apidra®
just before I sit down to eat. When I'm out at a restaurant, I wait for the food
to arrive and then I take my insulin within 20 minutes after I start eating.
Tip #5:
I always keep in mind the importance of doing what I can for my health because I
will benefit. Since I was eating 3 meals a day already, I just worked my Apidra® insulin
around each meal. As with anything it took a little while for the adjustment, but
this is another diabetes management task that can become a good habit.
Tip #6:
I learned that I could take my Apidra® within 15 minutes before or within 20 minutes after the start of a meal. This gives me flexibility.
Tip #7:
Starting on a mealtime insulin was easier than I thought it would be. Once I decided to do it, I started checking
my blood sugar before every meal and injecting Apidra® before I ate.
Tip #8:
Usually I eat breakfast and dinner at home and I have my Apidra®
insulin there. I keep an OptiClik® pen at my desk at work to use at lunchtime. When
I'm traveling, I take the pen with me wherever I go.
Tip #9:
I keep my Apidra® in my blood sugar meter case so that I have it
with me at all times.
Tip #10:
I check my blood sugar many times a day and always before and after meals.
Tip #11:
I use the OptiClik® pen and this makes it more convenient to take insulin at work and when away from home. I don't have to draw up Apidra®
from a bottle. I test my blood sugar before each meal and determine the amount of
carbohydrates I will eat and how much Apidra® insulin I'll need to take.
I do try to keep a regular meal schedule.
Tip #12:
I test my blood sugar frequently to keep on top of what my levels are doing. To tell
you the truth, its just part of my routine on a day to day basis. I don't think
much about it anymore.
Tip #13:
I take one day at a time and each meal in that day as a separate event. When I first
started taking mealtime insulin, I kept my carb counting books on the counter. I
kept a log of my carbs at each meal, my blood sugar levels and insulin. At first,
I tried to plan simple meals so I could manage my carbs better. The OptiClik®
pen has made it more convenient to get started in the first week or so. In the beginning,
I would take my carb counting books and my pen with me when we ate out. Now the
carb book stays at home, but the Apidra® is always with me.
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Determining how much Apidra® insulin to take
Tip #1:
Taking pre and post meal readings with your blood sugar
meter can help. You can share this information with your healthcare provider
and it makes it easier for him or her to make suggestions about your insulin dose.
Tip #2:
All of us are different, but getting to know your own body is really important.
I keep reminding myself how important it is for me to cover my meals with insulin.
Learning how to count carbs is a big help. Working with your doctor and possibly
a dietitian is important. The more you work to balance your food and your activities,
the better your blood sugar levels can be. It takes time, but it's worth it!
Tip #3:
In the beginning, I tested my blood sugar a lot - lots of finger sticks! For a while,
I tried to eat the same thing for a meal from day to day. For example, I always
had the same thing for breakfast. That made it easier to figure out the dose of
Apidra® and to see how my body reacted to the carbohydrates and insulin.
With my doctor's help I learned how rapid-acting insulin worked for me and I was able to determine the
ideal amount of insulin for a certain number of carbohydrates.
Tip #4:
Don't be discouraged - determining the right dose of Apidra® takes time. I started out logging everything
I ate and then tested my blood sugar 1, 2 and 3 hours after a meal to see what the various foods
would do to my blood sugar. But also remember, no two days are the same. I've discovered
that I use my logbook as a general guideline, not an absolute. It has really helped
me learn what to expect when eating different foods.
Tip #5:
I worked with my doctor to learn how to dose rapid-acting insulin. If I ran into difficulty (low blood sugar), I would
reflect on my intake of food, level of activity and amount of insulin. I wrote everything
down, took it to my doctor appointments and worked with my healthcare team. Now,
I take Apidra® only before dinner. I still take my long-acting insulin
and I manage my blood sugar levels with an active lifestyle and low carb diet. I
encourage everyone to find out what works for you! Write it down and work with your
doctor to develop a treatment plan that will work for you and your lifestyle.
Tip #6:
My healthcare professional used a formula to tell me how many insulin units of Apidra®
I needed for 1 serving of carbohydrate. If I am doing a lot of walking or other
exercise, I need to cut back a little more on my Apidra® dose. I made sure to adjust my mealtime insulin
by small amounts at a time. I also kept a log to see what foods and what activities
affected my blood sugar the most. I found it was really helpful to record all of
this and talk with my healthcare provider about it.
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Exercise and Apidra® rapid-acting insulin
Tip #1:
I learned from experience. I would check my blood sugar before I ate, then again
an hour and a half later. Ask your healthcare provider when you should test your
blood sugar after each meal. I also test my blood sugar before and after exercise.
It really teaches you the effect certain foods and exercise have on your blood sugar.
Then, you can adjust your Apidra® dose to go along with these factors. Remember to talk to your doctor before starting any exercise program.
Tip #2:
I generally exercise 1 hour after I eat lunch. I check my blood sugar before, during
and after I exercise. If I am going to do more strenuous exercise, I will eat a
few more carbohydrates at lunch. I worked with my healthcare professional to plan
this out.
Tip #3:
I usually have a set routine that I follow. Based on my activity each day, I
adjust the Apidra® dose. By recording it in a notebook, I found that I
quickly learned what activity does to my blood sugar levels.
Tip #4:
I learned over time to balance the amount of Apidra®,
food and activity. There are still times that I increase my activity and I forget to plan for it. I can feel my blood sugar dropping and I know I have
to do something. It's beneficial to have a snack with you all the time and
talk with your healthcare provider about the steps to take if your blood sugar drops.
Be prepared!
Tip #5:
In the beginning, I tested my blood sugar before and after each type of activity
to determine the effect of the activity on my blood sugar level. I wrote these down
so I could look back at them. I use this log to adjust my Apidra®
dose. For example, if I plan to walk after my noon meal, I'd look back at my journal
and see that a 20 minute walk reduces my blood sugar level by a certain amount.
Then, I would give myself less Apidra® than I had originally determined
I needed to cover my meal. If the walk was not planned, then I would check my blood
sugar level after the walk to be sure I was not getting a low blood sugar level.
If my blood sugar was low, I'd have a snack handy! This is what worked for me but
you should always check with your healthcare professional before adjusting your insulin
dose or exercising.
Tip #6:
I learned by doing - and telling my healthcare provider about my results. It really
comes down to observing how your body handles food, exercise and insulin. When I
am exercising, I usually reduce the amount of Apidra® I take at the
meal before the exercise. I worked with my healthcare provider to figure out how
much to reduce my Apidra® dose. Remember to talk to your doctor before starting any exercise program.
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Eating out with Apidra®
Tip #1:
I calculate the carbs as if I were placing the servings of each item on my plate.
When the meal arrives and the servings are too large, then I ask for a to-go box
and place the unneeded portion of each item in the box - before I start eating.
If I decide to indulge in the large portions, then I give myself a corrective insulin dose
of Apidra® immediately after eating or I do an activity, like walking,
that will reduce my blood sugar level.
Tip #2:
I make an educated guess about the carbohydrates in the meal that I ordered (based
on the foods in the meal). I take my Apidra® mealtime insulin before my meal comes.
Once the meal comes, I look at the plate and compare it to how much Apidra®
I took. If I think I took too little insulin for the portions, I just eat less,
leave excess on my plate or take a "to go" box. If I took too much insulin, I just
eat an extra piece of bread and that usually works.
Tip #3:
At a restaurant, I usually wait until I have eaten to take my rapid-acting insulin.
You can take Apidra® within 20 minutes after the start of a meal and
for me, that's usually when I'm done. I sometimes take Apidra® before
I eat. If I eat more carbs than I thought I would, I take more Apidra®
to cover it.
Tip #4:
I wait until the food comes out before I determine how much Apidra®
to take. I never try to guess before I see the food. Since restaurants rarely serve
too little, this technique (and not eating everything on my plate) seems to work
well for me. My advice is to find out what works for you. The most important thing
is managing your blood sugar and figuring out the best way to do this for you will
really help you.
Tip #5:
I usually select my meal before I take my rapid-acting insulin. Based on my meal
selection, I adjust the insulin dose.
Tip #6:
I usually have an idea of what I will eat and how large the portions are at our
favorite restaurants. The salad and meat, chicken or fish do not affect the carbohydrate
count of the meal. If I am going to eat bread, potatoes, or dessert, I estimate
the carbs and take my Apidra® after I've ordered.
Tip #7:
I don't take my insulin until I see what is on my plate and estimate how much I
will eat. I have taken nutrition courses where I learned how to count portion sizes
and this really helped me to get a grip on my carb counting. Sauces on food prove
to be my greatest challenge -- "sweeter" sauces can be very high in carbohydrates
and difficult to estimate. If it is a restaurant I go to often, I write down what
I ate, blood sugar readings 1, 2, and 3 hours after the meal and how much Apidra®
I took. That way, next time, I'll know what to expect. I also stay away from most
starches and opt for extra veggies instead. The exception to this is wheat or whole
grain dinner rolls.
Tip #8:
I don't take my Apidra® until my meal is on the table in front of
me. That way, I can see the portion size. I know which restaurants give big portions,
which ones have foods that I really like so I'll want to eat more of these and which
restaurants have a dessert that I really enjoy. This helps me determine my rapid-acting insulin
dose.
Tip #9:
I take my Apidra® after I start eating. With Apidra®, I am able to see just how much is on my plate and count the carbs.
If I forget to take it with my meal, I take it as soon as I'm done. You can take
Apidra® within 15 minutes before a meal or within 20 minutes after the start
of a meal. This makes it easier for me!
Tip #10:
If you take Apidra® before a meal, make sure you eat within 15 minutes
of taking it. Don't wait too long. At a restaurant, wait until the food arrives
before you take your insulin. If you plan to take your mealtime insulin before a meal, make sure
that there is bread at the table. Most important, always check your blood sugar
before taking insulin and after a meal (Ask your healthcare provider how long they
want you to wait after a meal to test your blood sugar).
Tip #11:
At your favorite restaurants, ask for the nutritional information for the foods
you like. I found that most restaurants will gladly give it to you.
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How to travel with Apidra® rapid-acting insulin
Tip #1:
I have a very small meter and use the OptiClik® pen. Both fit easily in a suit pocket, or on non-work days, in my coat or a
small fanny pack.
Tip #2:
I keep all of my testing supplies and my Apidra® mealtime insulin in a cosmetic bag
that travels in my purse.
Tip #3:
Always check with airlines to see about taking insulin and syringes on an airplane.
Tip #4:
In the summer time, I take a small cooler for my insulin if I'm going to be out
awhile in hot weather. There are lots of different kinds of cooler bags and ice
packs. They are advertised in the back of diabetes magazines and you can order them
directly from the company.
Tip #5:
I always have a bag packed with things I might need. I carry a sandwich in case
I need to eat. I also carry juice and glucose tablets in case of low blood sugar.
I have it ready at the front door and I just throw in the perishable items, like
the sandwich, and I'm ready to go.
Tip #6:
Using the OptiClik® pen makes it convenient. I take my meter, a
few needles, and my pen wherever I go. Everything fits in my pants pocket or jacket
pocket. For longer trips, I pack enough needles and insulin for the trip plus a
couple of days "just in case." I also make sure I have glucose tablets with me at
all times.
Tip #7:
I have found that by using the OptiClik® pen, you can take your shot
in public without disturbing the people around you.
Tip #8:
I used to fill insulin syringes before going out and this seemed to work well. But now that
I' am using the OptiClik® pen, I find it more convenient to carry and
take the right dose of Apidra® no matter where I am.
Tip #9:
I use vial & syringe which I keep in the same case with my meter. I use a small
meter that fits in my pocket. That way, I can take it everywhere I go. Blood sugar
testing is so important - so you can see what your blood sugars are throughout the
day. You'll know how to adjust your food, activity and insulin to better manage
your blood sugar level. In warm climates, I will use a cooler. And remember; always
throw out the opened vial after 28 days.
Tip #10:
I always have my meter, rapid-acting insulin and "quick sugar" (like glucose tablets,
5 - 7 Livesavers® or a juice box in my purse.
Tip #11:
I use the OptiClik® pen and I can give myself my Apidra®
very discreetly.
Tip #12:
I have several types of insulated carrying cases to fit different traveling needs
so I can keep the insulin at a proper temperature. It can really be a challenge
in Arizona where I live, especially when we're out riding in the desert. I ride
horses so I have insulated saddle bags. No matter where you like to go or hobbies
you have, there is a way to take your Apidra® with you! If you're
out a lot, you may want to consider a plug-in cooler for your car or truck. That
way, you'll have a mini-refrigerator with you.
Tip #13:
Always ask a hotel in advance (if possible) if they have a refrigerator in the room.
If they do not, ask where you can store your insulin during your stay. I have found
that most hotels are very nice about this.
Tip #14:
If I am traveling between time zones, I keep my watch on my local time until I arrive
at my destination and the next morning I adjust to the local time. Ask your healthcare
provider how they would like you to manage different time zones.
Tip #15:
I always have a letter from my physician with me when I travel. It states that I
require insulin and needles for injection and that I may require injections while
the airplane is in the air.
Tip #16:
I keep my insulin in my blood glucose monitor bag with a couple of syringes. I ride
a motorcycle. In hot weather, I use a cooler on my bike. I keep my insulin in the
bike bag under the seat.
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Getting started on Apidra®
Tip #1:
Learn about the way your body reacts after meals. I keep a daily record that helps
me know how my body reacts and then I can make decisions accordingly.
Tip #2:
Be cautious until you know how you will react. If you inject first and then leave
for lunch, make sure to carry glucose tablets. Take lots of pre and post meal readings
to gauge your own response to foods, insulin and activity. After a while, it will
become more predictable. Talk to your doctor about how often to check your blood sugar levels.
Tip #3:
Learn how to count carbohydrates. Ask your healthcare provider, see a dietician
if you can or go to the library and read books on it.
Tip #4:
Learn, learn and learn:
Learn how to count carbohydrates and how to adjust your insulin intake. Learn as
much as possible from your health care team. Learn where to inject.
Talk to your doctor, nurse, certified diabetes educator, and pharmacist to learn
as much as possible about whether starting a mealtime insulin regimen may be right for you.
Tip #5:
Be aware of hypoglycemia and how to deal with it. It is much less frightening if
you understand it and know what to do. Ask your healthcare provider about it.
Tip #6:
When you first start, try to keep your carbohydrate intake consistent so you can
better judge how much insulin you need for a certain number of carbohydrates. Then,
after some time, you can start to vary your diet to see how more or less carbs affects
your insulin dose.
Tip #7:
Keep a journal! Write your daily activities, including foods, insulin doses, blood
sugar readings, stress, etc. down in a logbook. Take it with you to your doctor
appointments and go over it with him or her. Ask what you can change to get better
blood sugar levels.
Tip #8:
Do not feel embarrassed by checking your blood sugar or taking insulin in public.
If you enjoy going out to lunch or dinner, keep doing so. Remember, you are doing
what you need to do to manage your blood sugar levels. Only you are hurt by not
doing the things that you know you should.
Tip #9:
Realize that the adjustment of mealtime insulin based on meals and activity is something
that does not come with a chart or book. Everyone is different and successful dose
adjustment comes from keeping a close eye on your blood sugar levels. After a while,
you'll have a handle on your system and know how it reacts.
Tip #10:
Ask your healthcare provider about the OptiClik® pen. Although I had a lot of
experience with syringes, I really liked switching to the pen. I would encourage
people to learn to use the pen, especially if you are just starting insulin.
Tip #11:
Apidra® can be taken within 15 minutes before or within 20 minutes after
a meal has started. This allows greater flexibility in your insulin dose. This can be beneficial
if you eat less than you thought you would or more than originally planned.
Tip #12:
Always have "quick sugar" - like glucose tablets, 5 - 7 Lifesavers®, or a tube of cake
decorating gel available in case you take your mealtime insulin and your food is
not available or you over-estimate the dose vs. what you ate.
Tip #13:
Find a certified diabetes educator in your area. Ask your healthcare provider or
visit aadenet.org. Get as much information as possible about diabetes.
Tip #14:
Know that it takes a while to get used to mealtime insulin. Be patient, test your
blood sugar often to see how it affects you and don't be afraid to make necessary
changes. Being successful using Apidra® as part of your daily routine
is about being proactive enough to manage yourself and undertand the circumstances.
Your doctor won't be with you everywhere you go and the best way is to learn to
be confident about the choices you make.
Tip #15:
Learn how to count carbohydrates. Counting carbohydrates is a beneficial
thing to learn when starting mealtime insulin. With Apidra®, I can
adjust my insulin dose based on the amount of food that I have actually eaten.
Tip #16:
Talk to your healthcare provider, others with diabetes and friends and family who
have experience with diabetes. Ask questions, repeat the question if necessary until
you understand. Realize you will make mistakes so remain positive. Keep a blood sugar log for
the first 2 or 3 weeks of meals, activities, insulin doses and blood sugar levels.
Stay focused on learning how to use Apidra®. There is so much to
learn about diabetes, so take one challenge at a time.
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