Preparing for Flu Season

Flu season is approaching, and that means many Canadians will find themselves coughing, sneezing, and dealing with other unpleasant symptoms. But are those symptoms due to a cold, influenza (“the flu”), or COVID-19? Here’s a guide to what you need to know about these illnesses.

Colds

Everyone gets a cold occasionally. A cold usually lasts a week or two, and the symptoms generally develop slowly over a couple of days. The symptoms include sneezing, stuffy nose, and sore throat, minor aches, and mild to moderate chest discomfort and cough. Colds don’t usually lead to serious health problems such as pneumonia, but occasionally complications can develop, including infections in the throat, ears, or sinuses. There are a number of steps you can take to reduce your risk of catching a cold:
• Wash your hands often.
• Keep your hands away from your face and avoid touching your eyes, nose, and mouth to prevent transferring the virus into your body.
• As much as possible, stay away from people who appear to be sick.
• Keep your immune system strong by eating a healthy diet and being physically active.
• Do not smoke. Smoking makes it more likely that you will catch a cold, and it makes the cold harder to get rid of.

There is no cure for a cold. Antibiotics will not help, because they fight bacteria but have no effect on viruses, and colds are caused by viruses. What you can do for relief is to treat the symptoms.

Here are some helpful tips:

• Drink plenty of fluids to help soothe a sore throat and thin the mucus in your nose and lungs. Hot fluids such as tea and broth can be especially helpful in relieving a stuffy nose.
• Take hot showers and use a humidifier in your bedroom to relieve a stuffy nose.
Saline drops may help drain thick or dried mucus.
• A dab of petroleum jelly can ease the discomfort of a red, raw nose.

If you decide to try cough and cold medicines, there are some things you need to know. These medications should not be given to children under six years of age. They won’t work on young children, and they may be harmful. For children age six and over, follow the instructions on the package carefully. Make sure you understand what the proper dose is and how often the dosing can be repeated. Whether these drugs are given to a child or an adult, if more than one is used, make sure they don’t contain any of the same ingredients, because you could risk getting an overdose of some ingredients by combining the recommended doses of several products.

Flu

Unlike colds, flu symptoms develop suddenly. In addition to cough, sore throat, runny or stuffy nose, and muscle or body aches, common flu symptoms include fever, chills, headache, and fatigue. The flu is more serious than a cold, and it can lead to pneumonia and worsening of some existing conditions such as asthma. And even though the flu is caused by a virus, it can lead to bacterial infections. The best way to avoid catching the flu is to get vaccinated—either by getting a flu shot or by getting the nasal spray vaccine. In general, the flu vaccine is recommended for everyone age six months and older; however, there are some people who should not receive the vaccine. Your healthcare provider is in the best position to advise you on the vaccine and whether the shot or the nasal spray would be best for you. The effectiveness of the vaccine varies from year to year, depending on how closely the vaccine matches the particular flu virus that is circulating each year. Even if you do catch the flu after being vaccinated, it is likely that your symptoms will be milder and that your flu won’t last as long.

One thing that is important to understand is that the flu vaccine cannot cause the flu. The same good health habits that will help keep you from catching a cold will also help prevent the flu. People who are at high risk of flu complications should check with their doctor as soon as they think they may be experiencing flu symptoms. People in this category include young children, adults age 65 and older, pregnant women, and those with certain chronic conditions such as heart disease, diabetes, and asthma.
If you do get the flu, antiviral drugs may provide a helpful treatment. Antiviral medications can lessen symptoms and shorten the time you are sick by a day or two. They can also help prevent serious complications.

To register to be notified via email when flu shots are available at your local store, click here.

COVID-19

COVID-19 is yet again adding another dimension to flu season. Symptoms can vary from person to person, and some people who are infected with the virus experience no symptoms at all. When symptoms do occur, they may include any of the following:

• Abdominal pain
• Chills
• Cough
• Diarrhea
• Fatigue or weakness
• Feeling feverish
• Feeling very unwell
• Headache
• Loss of the sense of smell or taste
• Muscle or body aches
• Shortness of breath or difficulty breathing
• Temperature of 38°C (100.4°F) or above
• Vomiting

Symptoms usually appear 5-6 days after exposure to the virus but it may take up to 14 days, or the virus can also be spread by people who have no symptoms. Getting 2 doses of COVID-19 vaccine is the best way to reduce your chances of becoming infected.

The most common ways the virus spreads are through:
• Inhaling the virus in respiratory droplets spread by a cough or sneeze
• Touching something that the droplets have landed on and then touching your eyes, nose, or mouth before washing your hands
• Personal contact, such as by hugging someone or shaking hands

You can reduce your chances of catching the virus by taking some basic precautions:
• Avoid crowded places, especially indoor areas with poor ventilation
• Avoid non-essential trips out of your home
• Do not gather in groups
• Stay at least 2 metres away from other people
• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer
• Wear a mask or face covering when out in public
• Get vaccinated

If you become ill and think you may have COVID-19, stay home from school or work and isolate yourself to avoid spreading the virus to others. If you live with other people, stay at least 2 metres apart at all times. Call your healthcare provider or 8-1-1 for assessment and possible referral to COVID-19 testing.

To learn more about COVID-19 vaccinations, click here.

 

Allergy Season is Here: How to Identify and Treat Your Symptoms

Budding blooms, runny noses and itchy eyes are often the tell-tale signs that allergy season has officially arrived. But with this year’s allergy season coinciding with the coronavirus pandemic, it has never been more important for seasonal allergy sufferers to be proactive about symptom management. It is also important to be aware of the difference between seasonal allergy symptoms and those caused by viral infections like the coronavirus or a cold.

Treating Seasonal Allergy Symptoms

While many people think of allergy medication as reactive, allergy sufferers should instead begin taking the medication before experiencing symptoms. Allergy medications can take a few weeks to become fully effective so by taking them proactively, you can save yourself a lot of suffering as the season intensifies.

Treating a variety of allergy symptoms can be a complex process, and it is important to choose the right medications, whether that is antihistamines, decongestants, sinus rinses, nasal sprays, eye drops or a combination. Pharmacists can help you differentiate seasonal allergy symptoms from other health issues, and determine the best treatment to target specific allergens and symptoms.

Allergen avoidance is another way to reduce seasonal allergy symptoms. Our pharmacists encourage allergy sufferers to keep windows shut and run air conditioning to recirculate air. Check daily pollen forecasts and limit outside exposure when pollen counts are at their highest. Consider using a HEPA filter at home to help reduce common allergens in the air such as mold, pollen, animal dander and dust mites.

Seasonal Allergy vs. Coronavirus Symptoms

While a wide variety of symptoms have been reported in connection with coronavirus, the two most common symptoms are a high fever and a cough. Seasonal allergies do not cause fever and, unless you have pre-existing asthma, they do not cause symptoms like shortness of breath. Symptoms more common of seasonal allergies include itchy or watery eyes and sneezing.

Symptoms of COVID-19 vary significantly from person to person. Some people may experience mild symptoms, while others have more severe symptoms. If you develop symptoms of COVID-19, self- isolate immediately, avoid contact with others and get tested for COVID-19.

Seasonal Allergy vs. Cold Symptoms

The similarities between cold symptoms and allergy symptoms can make it difficult to tell which condition to treat. While allergies and the common cold share many symptoms, those who experience seasonal allergies generally suffer from itchy, watery eyes and a runny nose. Symptoms of a cold may include aches and pains, a sore throat, and in some cases a fever and chills, which are not typical of seasonal allergies. A cold will generally only last about a week or two, whereas seasonal allergies will have much longer-lasting symptoms.

Have more questions? Visit the pharmacy at your local London Drugs, where our knowledgeable and experienced pharmacists can help answer any questions you might have about seasonal allergies and symptom management.

If you become ill and think you may have COVID-19, do not visit the pharmacy. Isolate yourself at home. You can access your province’s self-assessment tool at https://ca.thrive.health/covid19/en. Contact your healthcare provider for advice on how to relieve the symptoms.

 

BC Government Announces Additional AstraZeneca Vaccines Available at 20 London Drugs Locations in the Lower Mainland

London Drugs Opens Online Appointment Booking System for those Aged 55 to 65

April 5, 2021 – Richmond, B.C. – London Drugs will open up online appointment booking after the province has announced limited additional supply of the AstraZeneca vaccine. Starting at 12:45 pm (PST) on Monday April 5, those aged 55 to 65 can visit the online booking system at LondonDrugs.com/covid19 and follow the prompts to find available appointments.

2200 doses will be distributed amongst 20 London Drugs locations in the Lower Mainland before the end of day Monday April 5 with additional supply expected in the coming weeks.

“With the overwhelming demand, we are happy to see the government now accelerating the distribution of the vaccine through our pharmacies,” said Chris Chiew, General Manager of Pharmacy at London Drugs.

Patients will now be able to join a waitlist on a first-come-first-serve basis so that when vaccine inventory is depleted, they will be notified when more appointments become available. Patients on the waitlist will also be notified if there are “no shows” to previously booked appointments. Everyone wanting an appointment must go through the same online booking system.

“We are doing everything we can to quickly respond to changing vaccine supply and help the government ensure a widespread, easily accessible and equitable vaccination campaign as we do every year for flu,” said Chiew. “Thank you to our customers and patients for their patience. And to our pharmacy staff for their early efforts in what will be one of the largest public immunizations efforts ever undertaken in the province.”

For months, London Drugs pharmacists have been assisting with the Province’s vaccination efforts by administering the COVID vaccine on-site at various assisted living facilities and hospitals in B.C. to help speed up delivery to those most at-risk.

AstraZeneca Vaccines will be available for eligible British Columbians aged 55-65 at the following locations:

West Broadway

525 West Broadway

Vancouver, British Columbia V5Z 1E6

(604) 448-4804

North Vancouver

2032 Lonsdale Avenue

North Vancouver, British Columbia V7M 2K5

(604) 448-4805

Guildford Town Centre

10355 152 Street

Surrey, British Columbia V3R 7B9

(604) 448-4809

Granville and Georgia

710 Granville Street

Vancouver, British Columbia V6Z 1E4

(604) 448-4802

Lougheed Town Centre

9855 Austin Avenue

Burnaby, British Columbia V3J 1N4

(604) 448-4825

Kerrisdale

2091 W 42nd Avenue

Vancouver, British Columbia V6M 2B4

(604) 448-4810

London Plaza

5971 No.3 Road

Richmond, British Columbia V6X 2E3

(604) 448-4811

Coquitlam Centre

2929 Barnet Highway

Coquitlam, British Columbia V3B 5R5

(604) 448-4815

West Oaks Mall

32700 South Fraser Way

Abbotsford, British Columbia V2T 4M5

(604) 852-0936

Wessex – Kingsway

3328 Kingsway Avenue

Vancouver, British Columbia V5R 5L1

(604) 448-4828

 

Trenant Park Mall

5237 – 48th Avenue

Delta, British Columbia V4K 1W4

(604) 448-4837

Cottonwood Mall

45585 Luckakuck Way

Chilliwack, British Columbia V2R 1A1

(604) 858-9347

 

Park Royal North

875 Park Royal North

West Vancouver, British Columbia V7T 1H9

(604) 448-4844

Valley Fair Mall

22709 Lougheed Hwy

Maple Ridge, British Columbia V2X 2V5

(604) 448-4847

 

Ironwood Plaza

11666 Steveston Hwy

Richmond, British Columbia V7A 5J3

(604) 448-4852

41st & Victoria

5639 Victoria Drive

Vancouver, British Columbia V5P 3W2

(604) 448-4853

 

Mission

32555 London Avenue

Mission, British Columbia V2V 6M7

(604) 820-5115

Gibsons

900 Gibsons Way

Gibsons, British Columbia V0N 1V7

(604) 886-8720

 

Morgan Crossing

15850 26th Avenue

South Surrey, British Columbia V3S 2N6

(604) 448-4881

 

Garibaldi Village

40282 Glenalder Place

Squamish, British Columbia V8B 0G2

(604) 898-8270

 

 

 

Newly Diagnosed: Meeting the Challenge

You’ve just received the diagnosis: you have diabetes. This can be an overwhelming experience. You may feel shocked, stressed, or even depressed. You may have difficulty coming to terms with the fact that diabetes is a serious condition. Coping with a new diagnosis takes time, but with the right support you can do it. The good news is that there are many resources available to assist you in understanding the changes that you will have to make in your life.

Take control

You might be tempted to ignore the diagnosis and continue living your life as you have been, but taking control of your diabetes right away will deliver big benefits in the long run, helping you live a healthier life and preventing or delaying the development of complications. Taking an active role in managing your diabetes will help put you in control and make you feel better—both emotionally and physically. This means following your meal plan, being physically active, monitoring your blood glucose (blood sugar) levels daily, and being diligent about taking your medicines or injecting your insulin on schedule. Recording and monitoring your blood glucose readings will help you identify patterns that will enable you to see which factors are affecting your blood sugar levels and what lifestyle changes you may need to make.

Accept what you are feeling

The first step in learning to cope with the diagnosis is accepting that your emotions are likely to swing back and forth between feeling confident that you can manage your condition and struggling to cope with what might seem to be an endless list of new things to learn and do. That’s natural. You aren’t the only one to feel these things. Be kind to yourself and don’t expect perfection right away. There is always a learning curve; things take time. You can’t fix everything overnight. Don’t try to hide your diabetes from the people around you. Share your experiences with trusted family members, friends, and coworkers. They can be a resource for helping you cope when you are feeling sad, and they can help watch for signs that your diabetes may not be well managed. Starting a mood journal or diary may also help. This will provide a safe place to share your hopes and fears. By recording your emotions you may discover links between what you are doing physically and what you are experiencing emotionally. This can help you identify things in your life that you may want to change. As time goes on and you begin to adjust to the changes you are making in your life, you will start to become more comfortable and will begin to feel confident in your ability to manage your diabetes. Your negative feelings may return from time to time, because it is difficult to be positive all of the time. If your down moods don’t last too long, it’s probably nothing to be concerned about; however, if they start to take over your emotions, ask your healthcare provider if a professional counselor would be helpful.

Looking for help

It is important to learn everything you can about diabetes. The more you know, the better able you will be to manage the condition in a healthy manner. If you are looking for information on programs and services to help people newly diagnosed with diabetes, Diabetes Canada can help. Contact information for regional offices across Canada is available at https://www.diabetes.ca/contact-us/regional-offices. Your healthcare team is there to help you. Don’t overlook this important resource. Doctors, certified diabetes educators, dietitians, and pharmacists all have a role to play in helping you live a healthy life.

If you have any questions about managing your diabetes or about where to go for additional help, your London Drugs pharmacists are always happy to help.

Your Guide to Vitamins, Minerals & Natural Health Products

Vitamins & Minerals

Vitamins are organic substances, which means they come from living sources—plants and animals— and each vitamin has a special role to play in keeping our bodies healthy. Some vitamins are water-soluble (vitamins C and the B complex vitamins), and others are fat-soluble (vitamins A, D, E, and K). Water-soluble vitamins are readily absorbed by the body, and any of these vitamins that is taken in and not used right away is quickly excreted in the urine. That means we must get a fresh supply of these vitamins regularly. Fat-soluble vitamins are dissolved in fats. Unlike water-soluble vitamins, excess amounts of fat-soluble vitamins are stored in the body and can reach toxic levels. Some vitamins, such as vitamins A, C, and E, are referred to as antioxidants. Antioxidants may prevent or delay some types of cell damage, and they have been credited with many health benefits. Minerals are inorganic substances found in water and soil. Our bodies need more of some minerals (such as calcium, sodium, and potassium) but only very small amounts of others (including copper, iodine, and zinc).

The following below explains some of the ways vitamins and minerals work to keep our bodies healthy and functioning properly:

Vitamins

Vitamin A (retinol)
• Protects the eye; necessary for vision
• Helps keep skin, tissues, bones, and immune system healthy


Vitamin B1 (thiamine)
• Converts food to energy
• Needed for healthy blood, brain, skin, hair, muscles, brain, and nerve function


Vitamin B2 (riboflavin)
• Converts food to energy
• Needed for healthy blood, brain, skin, and hair


Vitamin B3
(niacin, nicotinic acid)
• Converts food to energy
• Needed for healthy blood cells, skin, brain, and nerve function


Vitamin B5 (pantothenic acid)
• Converts food to energy
• Helps make necessary body substances: lipids (fats), neurotransmitters, steroid hormones, and hemoglobin


Vitamin B6 (pyridoxine)
• May reduce the risk of heart disease
• Helps regulate sleep, appetite, and mood
• Needed for making blood cells
• Influences immune system and cognitive ability


Vitamin B7 (biotin)
• Converts food to energy
• Needed for healthy hair and nails
• Supports a healthy pregnancy
• Helps manage blood glucose (sugar) levels


Vitamin B9 (folic acid, folate, folacin)
• Vital for creating new cells
• Helps prevent brain and spine birth defects when taken early in pregnancy
• May reduce risk for heart disease, colon cancer, and breast cancer


Vitamin B12 (cobalamin)
• May lower risk of heart disease
• Helps make new cells
• Protects nerve cells


Vitamin C (ascorbic acid)
• Protects against cell damage
• Lowers the risk of some cancers
• Strengthens the immune system
• Helps make collagen (necessary for wound healing)
• Long-term use of supplemental vitamin C may protect against cataracts


Vitamin D (calciferol)
• Helps strengthen bones and teeth
• Supplements may reduce non-spinal fractures


Vitamin E (alpha tocopherol)
• Protects against cell damage
• Protects vitamin A and certain lipids (fats) from damage
• Diets rich in vitamin E may help prevent Alzheimer’s disease


Vitamin K (phylloquinone)
• Necessary for blood clotting
• May help prevent fractures


Minerals

Calcium
• Builds and protects bones and teeth
• Needed for muscle control, blood clotting, nerve transmission, activating enzymes, and secreting hormones
• Helps control blood pressure


Chlorine
• Balances body fluids
• Essential for digestion


Chromium
• Enhances activity of insulin
• Helps maintain blood glucose (sugar) levels


Copper
• Helps make red blood cells
• Needed for iron metabolism
• Supports immune system health


Fluoride
• Needed for bone formation
• Helps keep dental cavities from forming or worsening


Iodine
• Helps thyroid functioning
• Supports nerve and muscle health


Iron
• Needed for chemical reactions in the body
• Helps form red blood cells
• Plays a role in moving oxygen throughout the body


Magnesium
• Needed for many chemical reactions in the body
• Builds bones and teeth
• Necessary for muscle contraction, blood clotting, and regulation of blood pressure


Manganese
• Helps form bones
• Needed for metabolism of amino acids, cholesterol, and carbohydrates


Molybdenum
• Is part of several important enzymes


Phosphorus
• Converts food to energy
• Helps build and protect teeth and bones


Potassium
• Balances body fluids
• Maintains steady heartbeat, nerve impulses, and muscle contraction


Selenium
• Acts as an antioxidant, neutralizing molecules that can damage cells
• Helps regulate thyroid hormone activity


Sodium
• Balances body fluids
• Needed for muscle contractions
• Influences blood pressure


Sulfur
• Stabilizes proteins
• Needed for healthy hair, skin, nails


Zinc
• Needed for creating new cells and the formation of enzymes and proteins
• Plays a role in immune system health, taste, smell, wound healing
• When taken with antioxidants, it may delay the progression of age-related macular degeneration


How much is enough?

The amount of vitamins and minerals a person needs depends on a number of factors including the person’s age, general health, eating habits and, if the person is a woman, if she is pregnant or breastfeeding. A healthcare provider is in the best position to help you decide if you are getting all of the nutrients you need from your diet. If a supplement would be right for you, your London Drugs pharmacists can help you select the one that best meets your personal needs.

Supplements

The best way to get the vitamins and minerals we need is to follow Canada’s Food Guide and eat a variety of healthy foods, but we don’t always do that. And sometimes even eating a healthy diet doesn’t provide all of the nutrition we need. A supplement can help fill in the gaps. If you are short of only one or two nutrients, you may only need a supplement that provides a specific vitamin or mineral; however, if you aren’t getting enough of a number of nutrients, a multivitamin and mineral supplement might be right for you. Vitamin and mineral supplements are available in a variety of forms, including tablets, capsules, gel caps, gummies, and liquids. The supplement that is best for you will depend on how it works in the body and how you prefer to take it. For example, some work best in dry form, making a tablet or capsule the best dosage form; others work faster when taken as a liquid. If you have difficulty swallowing pills or capsules, you may prefer a liquid or chewable form. If you need help, your London Drugs pharmacist can advise you on what vitamins and minerals you may need and which dosage forms will work best for you.

Natural health products

Natural health products are substances that occur naturally and are used to maintain or restore good health. They may be derived from plants, animals, or microorganisms. While natural products are generally considered safe and have few side effects, they are not risk-free. It is important to remember that “natural” doesn’t necessarily mean “safe.” The chances of having a negative reaction to a natural health product increase when you combine supplements or use them along with medicines (prescription or over-the-counter), nicotine, caffeine, or alcohol. Talk with a healthcare professional before deciding to use a natural health supplement. This is particularly important for children, seniors, pregnant or breastfeeding women, and people with serious medical conditions.

Hypoglycemia: understand it, prevent it, treat it

Hypoglycemia is the medical name for low blood glucose (low blood sugar)—specifically, a blood glucose level below 4 mmol/L. Frequent or severe hypoglycemia can have a very negative effect on your diabetes management and your overall quality of life, making it important to be able to recognize the warning signs, to have strategies in place for preventing it, and to know how to treat it if it does occur.

Causes

Hypoglycemia may result from a number of factors including:
• not eating on time
• not eating enough
• getting more physical activity than usual
• taking too much medication
• drinking alcoholic beverages

Warning signs

The warning signs of hypoglycemia can vary from person to person, and some people don’t experience any warning signs at all. When warning signs do occur, they may include feeling:
• lightheaded
• shaky
• sweaty
• headachy
• hungry
• nauseated
• nervous, irritable, or anxious
• weak or drowsy
• unable to concentrate
• numbness or tingling in your lips or tongue
• fast heart rate

Very low blood sugar can cause:
• confusion and disorientation
• loss of consciousness
• seizures

Hypoglycemia can happen rapidly. Knowing the signs to watch for will enable you to treat it quickly.

Preventing hypoglycemia

It’s always better to prevent a problem than it is to be faced with the need to treat it, and these tips will help you prevent hypoglycemia:
• Follow the blood glucose monitoring schedule your diabetes care team has created for you. Careful monitoring is critical to making sure your blood sugar level remains within your target range.
• Eat on schedule. Don’t skip meals or snacks.
• Take your diabetes medication or insulin on schedule.
• If you are going to be very physically active, adjust your medication or have additional snacks.
• If you chose to drink alcohol, don’t do it on an empty stomach.
• Keep a log of your low glucose readings so you will be able to identify patterns.

Treating hypoglycemia

Sometimes, even the best efforts to prevent a problem aren’t enough. If you think your blood sugar may be low, check it immediately. If you don’t have access to your meter, treat the symptoms anyway. Treat hypoglycemia by eating or drinking 15 grams of a fast-acting carbohydrate, such as:
• 15 g of glucose in the form of glucose tablets
• 15 mL (1 tablespoon) or 3 packets of sugar dissolved in water
• 15 mL (1 tablespoon) of honey (Do NOT give honey to a child younger than one year of age.)
• 150 mL (2/3cup) of juice or regular (not diet) soft drink
• 6 LifeSavers® candies

Wait 15 minutes, then check your blood sugar again. If it is still low, treat it again with another 15 grams of fast-acting carbohydrates. Wait another 15 minutes, and then check it again. Keep doing this until your blood glucose is above 4 mmol/L. Once your blood sugar reaches 4 mmol/L, if your next meal is more than an hour away or if you are going to be physically active, have a snack that contains 15 grams of carbohydrate plus a protein source—such as half of a sandwich or cheese and crackers. Be sure to wait at least 40 minutes after your blood sugar reaches at least 5 mmol/L before driving, because your brain may need that long to recover before you can drive safely again.

If your blood sugar remains below 4 mmol/L or if you become sleepy and less alert, call 911 or your local emergency number immediately.

Severe hypoglycemia

Severe hypoglycemia in a conscious person is treated with 20 grams of fast-acting carbohydrates, preferably in the form of glucose tablets. Blood glucose should be retested in 15 minutes and retreated with another 15 grams of fast-acting carbohydrates if blood glucose remains below 4 mmol/L. Severe hypoglycemia in an unconscious person is treated with an injection of glucagon administered either subcutaneously (under the skin) or intramuscularly (into a muscle). The effectiveness of glucagon will be reduced in people who have consumed more than two standard alcoholic drinks in the previous few hours, in those who have been fasting, and in those who have advanced liver disease. People with diabetes should wear medical identification jewelry. That way, if they lose consciousness and are unable to speak for themselves, emergency responders will know what to look for and what to do.

Hypoglycemia in a child

Even mild symptoms in a child require immediate attention. In a child under six years of age who has symptoms, a blood glucose level below 6 mmol/L with symptoms is enough to trigger treatment. In a child at least six years old who has symptoms, a blood glucose level less than 4 mmol/L is enough for treatment.

Treatment will depend on the child’s weight.
• A child weighing less than 15 kg (33 lbs.) should be given 5 grams of carbohydrates.
• A child weighing between 15 and 30 kg (33 to 66 lbs.) should be given 10 grams of carbohydrates.
• A child weighing more than 30 kg (66 lbs.) should be given 15 grams of carbohydrates, the same as an adult.

5 grams of carbohydrate:
• 11/2 oz. (45 mL) of fruit juice
• 1/2 cup (125 mL) of white milk
• 1/4 cup (60 mL) of chocolate milk
• 1/4 cup (60 mL) of regular (not diet) pop
• 1-11/2 teaspoons (4-6 g) of jelly or jam

10 grams of carbohydrate:
• 3 oz. (90 mL) of fruit juice
• 3/4 cup (185 mL) of white milk
• 1/3 cup (80 mL) of chocolate milk
• 1/4 cup (60 mL) of regular (not diet) pop
• 2-3 teaspoons (8-12 g) of jelly or jam

Tips for family, friends, and coworkers

If you have diabetes, it is important that the people around you know what to do if your blood sugar drops too low. These tips will help:

If you are unconscious:
• The person should prepare a shot of glucagon and administer the shot following the instructions that came with the medication.
• As soon as the injection has been administered, the person should call 911 or your local emergency number.

If you are conscious and able to swallow:
• The person should lift your head and give you ½ teaspoon (7.5 mL) of water to swallow.

If you swallow the water without coughing or choking:
• The person should give you 15 grams of glucose tablets or 15 grams of fast-acting carbohydrates, then wait 15 minutes and see if you need help testing your blood glucose level.
• If you are feeling better but your blood glucose is still low or you still have symptoms, the person should give you another 15 grams of glucose tablets or fast-acting carbohydrates then wait with you for another 15 minutes until you test your blood glucose again.
• If you become sleepy or lethargic, the person should call 911 or your local emergency number immediately and stay with you until help arrives.

If you cough or choke on the water:
• The person should turn you on your side and make sure your airway isn’t blocked.
• Then the person should prepare a shot of glucagon and administer the shot following the instructions that came with the medication.
• As soon as the injection has been administered, the person should call 911 or your local emergency number.
• If you are unconscious and emergency help hasn’t arrived within five minutes, the person should give you another glucagon shot and stay with you until the emergency help arrives.

Diabetes & Covid-19

COVID-19 is a virus that affects the respiratory system (the system that enables us to breathe). People with diabetes are not more likely than others to catch the COVID-19 virus, but if they do catch it, they are more likely to have a severe form of the infection and to suffer more complications. This makes it particularly important for people with diabetes to do everything they can to protect themselves from this virus. Here are some things you can do to help protect yourself.

• Wash your hands thoroughly and often with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer.
• Avoid touching your eyes, nose, and mouth.
• Regularly clean commonly used surfaces and devices you touch or handle.
• Don’t make unnecessary trips away from home.
• If you do have to leave your home, try to stay at least 2 metres away from anyone else.
• Avoid contact with people who appear to be sick with a respiratory illness.
• Watch carefully to see if you develop any symptoms.

Common symptoms of COVID-19 to watch for include fever, tiredness, dry cough, aches and pains, nasal congestion, runny nose, sore throat, and diarrhea. However, some people who become infected with the virus never develop symptoms. If you do develop any of the symptoms, continue following your diabetes management plan and call your doctor to see whether you should make an appointment to go in for a checkup and for advice on how to treat your symptoms. Research has shown that insulin and other treatments for blood sugar control do not increase the risk of severe COVID-19, and you should continue to take them. In fact, you should not make any changes to your diabetes management plan without checking first with your doctor. It is always better to be prepared than to be surprised by something unexpected. For people with diabetes, this includes having a sick day management plan in place before you get sick.

The article “Sick Day Management” below will help you prepare for COVID-19 or any other illness you may develop.

Sick Day Management

Even a minor illness can cause serious problems for people with diabetes. When we are sick, our body reacts by releasing hormones to fight infection, but this can raise blood glucose (blood sugar) levels and make it more difficult for insulin to lower blood glucose. A little planning can reduce the likelihood of developing dangerously high blood glucose levels if you get sick.

Plan ahead
While you are still healthy, you should talk to your doctor or diabetes care team to create a sick day management plan. Your plan should include your target blood glucose goal during an illness, how often to test your blood glucose and ketone levels, how your diabetes medication schedule or insulin might have to be adjusted, if you should stop taking any other medications, and what warning signs indicate it’s time to contact a doctor. Make sure you keep your sick day management plan where it will be handy when you need it. Prepare a sick day kit that includes:
• glucose tablets to treat hypoglycemia (low blood sugar)
• sugar-free beverages
• a thermometer
• enough blood glucose testing strips
• a ketone meter and strips

Managing your blood sugar
If you are on insulin, continue taking it even if you are vomiting or have trouble eating or drinking. If you are managing your diabetes with medications or if you are taking medicines for other conditions, you may need to stop taking them if you are at risk of becoming dehydrated as a result of vomiting or diarrhea.

Speak with your doctor if you take any of these types of medicines to make sure you know what to do if you get sick:
• blood pressure medications
• diuretics (“water pills”)
• nonsteroidal anti-inflammatory drugs (NSAIDs)
• pain medicines
• sulfonylureas

Be careful about taking over-the-counter medicines. For example, if you have a cough or cold and you are looking for relief from your symptoms, you should be aware that some products contain sugar. Ask your London Drugs pharmacist for assistance in choosing a product that will help you feel better without affecting your blood glucose control.

Stay hydrated

If you are vomiting, have diarrhea, have a fever, or are exposed to excessive heat, you are at risk of dehydration. Be sure to drink plenty of fluids that contain minimal or no sugar. Try to drink at least one cup (250 mL/8 oz.) of sugar-free fluids periodically for a total of at least nine cups (2.2L/72 oz.) daily to prevent dehydration. Good choices of fluids include water, clear soup or broth, herbal tea, and caffeine-free diet pop (such as diet ginger ale). Limit the amount of caffeine-containing beverages you drink (e.g., coffee, some teas, and some types of carbonated soft drinks), because caffeine makes dehydration worse. You may want to consider electrolyte replacement solutions.

Eating while you are sick

If you can, try to stick with your meal plan. If you can’t eat the foods you usually eat, try to consume light foods or fluids that contain 15 grams of carbohydrates every hour. Options include:
• 1 slice of bread
• 7 soda crackers
• 1 medium-size piece of fruit
• 1 twin popsicle
• ¹/2 cup (125 mL) of unsweetened applesauce
• ¹/2 cup (125 mL) of 100% fruit juice
• 2/3 cup (165 mL) juice
• ¹/2 cup (125 mL) regular Jell-O®
• 2/3 cup (165 mL) regular soft drink that does not contain caffeine
• ¼ cup (60 mL) regular pudding or ½ cup (125 mL) sugar-free pudding

If you are not vomiting and don’t have diarrhea, you may also want to try:
• 1 cup (250 mL) of milk
• ¹/2 cup (125 mL) of flavoured yogurt
• ¹/2 cup (125 mL) of ice cream

If you are eating less than normal and the symptoms last for more than 24 hours, you may need to temporarily stop taking some medications, including certain diabetes pills, blood pressure and heart medications, and anti-inflammatory pain medicines, and you may need to stop taking all diuretics (water pills). Check with your healthcare professional before you get sick to find out if any of your medications should be stopped, and incorporate this into your sick day management plan.

Test, test, test
Your sick day management plan should include instructions for what tests you should perform and how often to do them, but the following are some general guidelines to consider:
• Check your blood glucose at least every two to four hours. If it is rising quickly, check it more often, even throughout the night.
• If you take insulin, test your blood or urine for ketones.
• If your blood glucose tests above 16 mmol/L twice in a row, test your blood or urine for ketones every four hours.
• Weigh yourself and check your temperature, breathing rate, and pulse frequently.

When to seek help
There are some warning signs that point to a more serious problem. You should contact your healthcare provider if:
• You are sick for more than 24 hours and aren’t getting better or if you start to feel worse
• You can’t drink enough liquids
• You take any medicines and aren’t sure if you should change your dosage or stop taking them when you are sick
• You take insulin and aren’t sure if or how you should change your dosage
• You have been told to check your ketones and they are moderate to high
• You are unable to keep your blood glucose level above 4 mmol/L

If you can’t reach your healthcare provider and are not getting better, consider going to the emergency
department of your local hospital.

Read all other articles in our Living with Diabetes Magazine here.

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