Blood Glucose Monitoring

Self-monitoring of blood glucose (blood sugar) levels is a critical part of managing
diabetes, because it provides a picture of how well blood glucose is being controlled. In addition to providing an indication of long-term control, it helps identify impending problems, and this allows people to make necessary adjustments to prevent highs and lows. For example, if blood glucose drops, the person can eat something; if it rises, a medication adjustment may be necessary.

Traditionally, blood glucose self-monitoring has been done using a blood sample obtained by pricking part of the body—usually a finger—with a lancet and applying the sample to a special strip that is read by a glucose testing device.

Continuous glucose monitoring

Another testing option is also available. Called continuous glucose monitoring (CGM), it involves a small, disposable sensor that is worn under the skin (commonly on the arm or stomach) and tests blood glucose every few minutes all day and night. The readings are sent to a transmitter and usually to a separate device as well, allowing the data to be read by the patient, caregiver, or healthcare provider. The CGM can also be paired with an insulin pump, which is called integrated CGM.

CGM is a good option for some patients, because:

• It allows people to see their blood glucose reading 24 hours a day with few—or
sometimes even no—finger prick tests.

• It improves the ability to identify glucose patterns, so daily management decisions can be made in a timely manner.

• Because CGM monitors blood glucose continually, it can be particularly helpful overnight when regular testing is not likely to be done. Alarms and alerts can warn users when blood glucose drops too low.

• It provides more information than sporadic finger prick tests. The device shows the current glucose reading, a graph of glucose readings over the previous hours, and
the rate of change in the levels.

• The ease of use and greater information provided can lead to improved glycemic control.

According to Diabetes Canada, there is evidence to suggest that CGM may be beneficial for both adults and children with type 1 diabetes who have not achieved their blood glucose targets or who have difficulty with hypoglycemia.

Diabetes apps

Apps that help manage blood glucose have been shown to be beneficial in improving the health of people with diabetes. Many diabetes devices—including glucose meters, continuous monitors, and insulin pumps—come with integrated apps that sync the device to a mobile phone. A diabetes educator can help you learn how they work.

The bottom line

Diabetes management must be individualized. People living with diabetes should work with their healthcare team to determine the meal plan, activity program, blood glucose monitoring device and schedule, and the diabetes supplies that will best meet their personal needs.

Your London Drugs pharmacists are always happy to answer your questions and counsel you on products to help you manage your diabetes and lead a healthy life.

Seasonal sadness: Don’t be sad

Seasonal sadness—also known as seasonal affective disorder or SAD—is a type of depression that relates to the changing seasons. In most cases of SAD, the symptoms start in the late autumn and continue through the winter months, which is why the condition is often referred to as the winter blues. In some cases, though, the symptoms begin in the spring or summer. In either case, symptoms may be mild when they begin and become more severe as the months move on.

Symptoms of SAD may include:

• Feeling depressed most of the day nearly every day
• Feeling hopeless, worthless, or guilty
• Having low energy
• Feeling sluggish or agitated
• Having difficulty sleeping
• Losing interest in activities that were usually enjoyed
• Experiencing changes in appetite or weight
• Having trouble concentrating
• Having frequent thoughts of death or suicide

Symptoms that are specifically connected with SAD that occurs during the fall and winter include:

• Oversleeping
• Craving foods that are high in carbohydrates
• Gaining weight
• Feeling tired or having low energy

The shorter days in the fall and winter appear to be the main triggers for the winter blues, because the reduced hours of sunlight can disrupt the body’s internal clock. During the daylight hours, our brain sends signals to the other parts of our body to help keep us awake and alert. At night, our brain produces a chemical called melatonin that helps us sleep. As the days get shorter and the nights get longer, our bodies get out of balance.

Treating SAD

A first line of treatment for SAD is often light therapy. In light therapy the person generally spends at least 30 minutes a day in front of a box that shines a light much brighter than ordinary indoor lighting. As many as 70% of people find relief after a few weeks of treatment; some find relief even sooner. However, light therapy doesn’t work for everyone. Antidepressants can be effective in some cases, either alone or in combination with light therapy. There is growing evidence to support cognitive behavioural therapy (CBT) as a viable treatment for SAD. CBT is a type of talk therapy that helps people identify negative thoughts and reframe them into something more positive. It also helps them discover new behaviours to engage in
to make them feel better when they are depressed.

Some behaviours that may help are:

• Taking a walk, watching a movie, or engaging in other activities you enjoy
• Getting outdoors early in the day when the sun is shining or spending time in
brightly lit spaces
• Eating a healthy diet and limiting the amount of carbohydrates, such as cookies and
candy
• Spending time with a trusted friend or relative you can share your feelings with
• Getting together with friends
• Volunteering in the community to help others

If self-help measures don’t relieve the problem, consult your doctor. This is especially important if your sleep patterns have changed, if you find yourself drinking more alcohol for comfort or to help you relax, or if you feel hopeless or think about suicide.

Read other articles in our Fall-Winter 2021 volume of our Bettercare magazine here.

Winter First Aid

As autumn turns to winter and the snow begins to fall, we have to be prepared to deal with typical winter dangers. With ice covering sidewalks and driveways, our risk of falling increases, bringing with it an increasing number of sprains and strains. And dropping temperatures make us vulnerable to hypothermia and frostbite. Here are some guidelines to help you deal with these winter emergencies.

Sprains and strains

Sprains and strains occur when joints, muscles, tendons, and ligaments are stretched beyond their normal range—for example, as a result of falling on an icy surface. To treat one of these injuries, remember the acronym RICE, which stands for rest, ice, compression, and elevation.

Rest the injured limb. Avoid putting weight on the area until it has healed.

Ice the injury to prevent swelling, but don’t apply the ice directly to the skin. Place a thin cloth between the ice and the skin, then keep the ice in place for about 20 minutes each hour.

Compress the injury with an elastic bandage or specialized sleeve. This will provide support to the injured area and help prevent swelling.

Elevate the limb to a level above the heart. This makes it difficult for the heart to pump blood to the injury and cause swelling.

In addition, nonprescription pain relievers, such as acetaminophen or ibuprofen, can ease the discomfort, but don’t give ASA to anyone under the age of 18. Your London Drugs pharmacists can help you select the best medication to meet your needs.

Hypothermia

If your internal body temperature drops below 35° C (95° F), you can slip into hypothermia, a state when the body’s temperature is not high enough to support normal metabolism. Children, the elderly, and people with a low percentage of body fat have a higher risk of developing this problem.

Hypothermia causes moderate to severe shivering, mental confusion, lack of coordination, and a change in the heart rate—either a significant increase or decrease. The extremities may turn blue, and the skin may become very pale, blue, or swollen.

If you suspect that someone has hypothermia, call 911 immediately. If the person either stops breathing or the breathing becomes very shallow or slow, begin CPR. If CPR isn’t necessary, try to get the person away from the cold. Take the person inside and if the clothing is wet, help the person change into dry clothing. If that isn’t possible, wrap the person in a warm blanket and try to get the person off the frozen ground.

Applying heat to the body can cause injury. A better option is to apply a warm compress to the central areas of the body—head, neck, chest, groin. Do not give the person alcohol or massages.

Frostbite

Frostbite happens when the skin and tissue beneath it freeze up and damage the cell walls. The fingers, cheeks, chin, ears, and nose are the most vulnerable areas.

Signs of frostbite include skin that has either turned red or has become very pale, skin that is hard or looks waxen, and feelings of prickling or numbness. Very severe frostbite can cause blisters and significant pain.

If someone near you appears to have frostbite, get the person out of the cold if possible. If that isn’t possible, cover the part of the face that appears to be affected or tuck the hands into the armpits to warm them up. Remove any pieces of wet clothing. Do not rub the skin, as this can cause further damage.

Once you have the person in a warm environment, soak the frostbitten area in warm—not hot—water for 15 to 30 minutes. Avoid using direct heat such as a heating pad or fireplace. Over-the-counter pain relievers may be helpful, as rewarming can be uncomfortable. As frostbitten skin warms, it should turn red as sensation returns. If the area stays numb or if blisters develop, seek medical attention.

Your winter first aid kit

An important part of preparing for winter emergencies is to have a properly stocked first aid kit on hand. Here are some general guidelines for what to include, but your London Drugs pharmacists can help you customize a kit for your family’s needs.

• absorbent compress dressings
• adhesive bandages (assorted sizes)
• adhesive cloth tape
• antibiotic ointment
• antiseptic wipes
• elastic bandages
• emergency blanket, mittens, socks, hat
• first aid instruction manual
• hand sanitizer
• hydrocortisone cream
• instant cold compress
• instant hand or foot warmers
• non-latex gloves
• oral thermometer (non-mercury/non-glass)
• OTC pain reliever
• scissors
• sterile gauze pads
• tweezers

Read other articles in our Fall-Winter 2021 volume of our Bettercare magazine here.

Strengthen Your Immune System

The immune system is the body’s main defence against organisms that cause diseases. A healthy immune system is key in keeping us from becoming ill. That makes boosting our immune system a worthy goal, but there is still much that remains unknown about how to achieve this goal. Unfortunately, there is no magic formula that improves immune function. However, that doesn’t mean we should give up on it. There are some things that we know can keep our immune systems working properly. As with every other part of our body, our immune system functions better when we choose healthy lifestyle habits that help protect it from attack by organisms present in our environment.

Healthy habits

Among the lifestyle choices that will help promote the health of your immune system are:

• Not smoking

• Eating a healthy diet high in vegetables and fruit

• Limiting alcohol consumption

• Getting regular physical activity

• Maintaining a healthy weight

• Getting enough sleep

• Dealing with stress in a healthy manner

• Practicing careful hygiene to prevent infection (such as frequent hand washing with soap and water, avoiding close contact with people who appear to be ill, and cooking meats thoroughly)

• Getting all of the vaccines your healthcare team recommends for you

Diet and immune function

To work properly, the immune system needs nourishment. Scientists believe this is why people who live in poverty and are malnourished are more likely to contract infectious diseases. There also seems to be a connection between nutrition and immune function in the elderly. Our immune response lessens as we age, and older people are more likely to experience what is known as micronutrient malnutrition—a situation in which a person doesn’t get enough of some essential vitamins and trace minerals, either through their diets or from taking supplements. If you suspect that your diet is not providing you with all of the nutrients you need, taking a daily multivitamin and mineral supplement may be of benefit, but taking mega doses of a single vitamin will not. If you have questions about whether you should take a supplement or about which supplement would be right for you, our pharmacists are available to advise you.

Stress and immune function

Science has come to recognize how closely the mind and body and linked, but there are still a lot of unknowns. Some researchers are investigating how stress affects the immune system. Most of the research is looking at constant, frequent stressors such as those caused by relationships with family, friends, and coworkers, or sustained career challenges rather than at a sudden, short-lived stressor. There are healthy and unhealthy ways of dealing with stress. Consuming alcohol to help you relax is an example of an unhealthy way. Examples of healthy options include meditation, yoga, tai chi, practicing mindfulness, and seeking professional counselling.

Physical activity and immune function

Just as eating a healthy diet contributes to general good health and, therefore, a healthy immune system, so does getting regular physical activity. Following general guidelines for healthy living is the single best thing you can to do strengthen your immune system and safeguard yourself from disease-causing organisms.

Read other articles in our Fall-Winter 2021 volume of our Bettercare magazine here.

Could you have diabetes?

On average, every day 480 Canadians are diagnosed with diabetes, more than 20 Canadians die of diabetes-related complications, and 14 Canadians have a lower limb amputated due to diabetes. Could you have diabetes and not know it? It is important to know whether you have diabetes, because if you are aware of it, you can take steps to manage your condition and lead a healthier life. However, if left untreated, diabetes can cause very serious complications.

Different types of diabetes

There are several different types of diabetes:

• Type 1 diabetes is a condition in which the body’s immune system destroys the insulin-producing cells of the pancreas, making the affected people dependent on injecting insulin into their bodies. Type 1 diabetes usually develops in children and youths, but it can occur in adults as well.

• Type 2 diabetes occurs when the pancreas does not produce enough insulin or the body cannot properly use the insulin it produces. In some cases, type 2 diabetes can be managed with oral medication, but some people with type 2 will need to inject insulin.

• Gestational diabetes may develop during pregnancy if a woman’s blood sugar reaches too high a level. It usually disappears following delivery of the baby, but it increases the woman’s chances of developing type 2 diabetes.

What causes diabetes?

There is a lot of misinformation about diabetes floating around. For example, diabetes is not caused by eating too much sugar, and people do not give themselves diabetes. The causes of diabetes depend on the type of diabetes the person has—type 1 diabetes, type 2 diabetes, or gestational diabetes. Among the possible causes are your genes, family medical history, ethnic background, and your general health.

Symptoms

Some people with diabetes don’t experience any obvious warning signs, but those who do may have some of the following symptoms:

• cuts and bruises that are slow to heal
• lack of energy or extreme fatigue
• frequent or recurring infections
• unusual thirst
• frequent urination
• tingling or numbness in the hands or feet
• trouble achieving or maintaining an erection
• blurred vision
• weight loss or weight gain

Prediabetes

Prediabetes is a condition in which blood glucose (blood sugar) levels are higher than normal, but not high enough to be diagnosed as diabetes. Nearly six million Canadians have prediabetes. If left untreated, prediabetes can develop into type 2 diabetes. If you have prediabetes, taking steps to manage your blood glucose levels can help prevent you from developing diabetes.

Managing blood glucose

There are several measures you can take to help manage your blood glucose levels:

• Eat a healthy diet
• Be physically active
• Achieve and maintain a healthy body weight
• Monitor your blood glucose levels regularly
• Take any medication your doctor prescribes exactly according to the directions

Diagnosing diabetes

If you think you or someone you know may have diabetes, seek medical attention as soon as possible, so you can begin managing the condition and prevent complications. There are several tests used to diagnose diabetes:

• Fasting blood glucose test
• Random blood glucose test
• A1C test
• Oral glucose tolerance test

While diabetes cannot be cured, it can be managed, and people with diabetes can lead happy, fulfilling lives. Diabetes Management Clinics are also available at London Drugs for one-on-one consultations.

Read other articles in our Fall-Winter 2021 volume of our Bettercare magazine here or learn more about the Diabetes services offered at London Drugs.

Cold & flu season

Colds and the flu are both respiratory diseases caused by viruses and can spread through respiratory droplets released when a person breaths, coughs, sneezes, talks, or sings. You can catch the virus when it lands on your mouth or by breathing it in through the nose. Touching an object the virus has landed on and then touching your mouth, nose, or eyes can also introduce the virus into your body.

Cold & flu: what’s the difference?

While a cold and the flu share many of the same symptoms, there are differences, and it is important to know what they are. Currently, flu season is being complicated by COVID-19, a respiratory infection that produces similar symptoms to the seasonal flu. The following table will help you determine if your symptoms are due to the common cold, seasonal flu, or COVID-19.

Cold symptoms:
Usually appear one to three days following exposure to a cold-causing virus.

Flu symptoms:
Usually appear one to four days after exposure to an influenza virus.

COVID-19 symptoms:
Usually appear between two days and two weeks after exposure to the SARS-CoV-2 virus.

Relieving symptoms

There are no medicines that can cure a cold or the flu. If you think antibiotics can help, you’re mistaken. Antibiotics kill bacteria, but they have no effect on viruses. There are some prescription antiviral medicines that can help make symptoms milder and help you feel better faster, but they don’t actually cure the disease. There are also a variety of over-the-counter medicines that can help relieve symptoms:

• Analgesics can help relieve aches and pains.

• Antihistamines can help dry out a runny nose.

• Decongestants can help unclog a stuffy nose.

• Expectorants can help loosen mucus, making it easier to remove it through blowing your nose or coughing.

• Antitussives can help suppress a cough.

• Lozenges and analgesics can help relieve a sore throat.

• OTC cold medicines can also help provide relief.

Not every product is right for every person. It is important to read the product labels carefully and follow the directions exactly. If you aren’t sure which products might be right for you, our pharmacists will be happy to answer your questions and advise you on appropriate medications.

Prevention is the best option

It’s always better to prevent a problem than to try to fix it after it happens. Fortunately, there are steps you can take that will help you avoid getting a cold, the flu, or COVID-19. While there is no vaccine that can prevent the common cold, there are vaccines that can drastically reduce your chances of getting the flu or COVID-19. If there are no medical reasons prohibiting you from getting vaccinated, you should seriously consider vaccination. Your healthcare provider can advise you on whether this is the right decision for you.

There are also other steps that you can take to protect yourself against contracting a respiratory disease:

• Stay at least two metres (six feet) away from anyone who isn’t a member of your household.

• Wear a mask or other face covering in indoor public spaces and outdoors if you are in a crowd.

• Avoid close contact with anyone who appears to be sick with a cold or the flu.

• Wash your hands frequently with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains at least 60% alcohol.

• Clean and disinfect high-touch surfaces such as light switches, doorknobs, countertops, telephones, and other electronic devices daily.

• Wash children’s toys periodically.

• Don’t share drinking glasses or eating utensils with anyone, not even family members.

Because the flu and COVID-19 cause such similar symptoms – or in some cases, cause no symptoms at all – it can be difficult to diagnose which condition a person has based solely on symptoms. There are tests that can determine which disease a person has. It is important to contact a health professional for an assessment if you are experiencing any of these symptoms. They may suggest testing for COVID-19 or self-isolation. Stay home from school or work if you are feeling unwell to prevent the spread of infections.

If you have any questions about treating coughs, colds, or the flu, or if you have any questions about COVID-19, your London Drugs pharmacists are always happy to help you.

Read other articles in our Fall-Winter 2021 volume of our Bettercare magazine here.

 

Know yourself: cancer self-exams

Early diagnosis of cancer improves outcomes by starting treatment at the earliest possible stage when treatment is most likely to be successful. An important step in early diagnosis is spotting changes in your body and bringing them to the attention of your doctor so the reason for the changes can be identified. Self-exams play an important role in helping you spot changes. A good place to start is with your skin.

Skin self-exam

When caught early, skin cancer is highly curable. The best way to recognize changes to your skin is to examine yourself head-to-toe every month.

What to look for:

• A new growth or an existing growth that changes in size and appears pearly, transparent, tan, brown, black, or multicoloured

• A mole, birthmark, or brown spot that gets larger than a pencil eraser, becomes thicker, or changes in texture or colour

• A spot or sore that continues to itch, hurt, bleed, crust, or scab

• An open sore that does not heal within three weeks

How perform a skin self-exam:

• Inspect your face, especially your nose, mouth, and the front and back of your ears. Use mirrors to get a clear view.

• Thoroughly inspect your scalp. Use a blow dryer to separate your hair and expose every section of your scalp so you can view it with a mirror. It may be easier if you can get a family member or friend to help.

• Scan your hands and arms. Look at your palms, the back of your hands, and between your fingers. Continue up your wrists and arms, and don’t forget your underarms.

• Check your torso. Start with your neck and move down to your chest, including the undersides of your breasts, then your abdomen.

• Inspect your back. Stand with your back to a full-length mirror and hold a hand mirror, moving it as needed so you can view your whole back, including your neck, shoulders, upper back, lower back, and buttocks.

• Examine your genitals using a hand mirror.

• Scan your legs, front and back, using a hand mirror where necessary. Start at your thighs, move down your shins to your ankles, and finish with your feet, including the soles and your toes.

Breast self-exam

There is some debate about the value of breast self-exams in detecting breast cancer early when treatment has the best chance of being successful. While some healthcare professionals question the value of these exams, many physicians and health-related organizations firmly believe that breast self-exams are an important screening tool, especially when used in combination with regular physical exams by a doctor, mammograms, and sometimes ultrasound or an MRI.

What to look for:

• A change in size, colour, or shape of the breast

• Any lump, swelling, or distortion

• Breasts that are unevenly shaped

• Dimpling, puckering, or bulging skin

• Redness, soreness, or rash

• A nipple that has changed position or turned inward instead of sticking out

• Signs of fluid coming out of one or both nipples

How to perform a breast self-exam:

• Begin by standing in front of a mirror with your shoulders straight and your hands on your hips, and inspect your breasts carefully, turning from side to side so you can see all areas of your breasts. Alternatively, you can perform the exam while lying down using a hand mirror. If you do it lying down, your breast tissue will spread out and become thinner, making it easier to feel what’s below the skin. Another option is to do it in the shower with your breasts lathered, making it easier for your fingers to glide smoothly across your skin.

• Using the pads of your fingers, not your finger tips, examine your left breast with your right hand and your right breast with your left hand. Keeping your fingers flat and together, use a circular motion to feel for anything unusual. Cover the whole breast area from your collarbone to the top of your abdomen and from your armpit to your cleavage.

Testicular self-exam

A testicular self-exam is a simple pain-free test that helps a male become familiar with his testicles so he will be able to notice any changes.

What to look for:

• A lump

• Pain or swelling in the scrotum

• Any change in size, shape, tenderness, or sensation

• A soft collection of thin tubes above the testicles

• A testicle that you cannot feel because it has not properly descended into the scrotum

How to perform a testicular self-exam:

• This test is best performed standing, either during or just after a shower when the scrotal skin is warm and relaxed.

• Gently feel the scrotal sac to locate the testicles.

• Using one hand to stabilize the testicle, use the fingers and thumb of the other hand to firmly but gently feel the entire surface of the testicle.

• Repeat the procedure on the other testicle.

The next step

Self-exams are just the first step in the early diagnosis of any health problem. If you notice anything unusual or anything that concerns you, see your doctor for further testing to identify the cause of the issue. That way, if there is a problem, it can be addressed at a stage when treatment is most likely to be successful.

Read other articles in our Fall-Winter 2021 volume of our Bettercare magazine here.

 

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