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.

Health Tips Video: How to Manage Diabetes for a Long, Healthy Life

Tips to manage diabetes for a long and healthy life

Diabetes is a serious medical condition that affects over 2.1 million people in Canada. There are different types of diabetes, but all forms affect the body’s ability to manage blood sugar levels with insulin. Either the body has difficulty producing insulin in the pancreas (Type 1), or it cannot properly use the insulin it does produce (Type 2). There is also a temporary type of diabetes that can affect women during pregnancy. Gestational diabetes affects 2-4% of pregnancies and means that both mother and child have a higher risk of developing Type 2 diabetes later in life.

Thankfully, there are many ways to manage diabetes. According to London Drugs pharmacist Sangita Tumber, it is important for people with diabetes to:

  • Interpret blood sugar patterns
  • Eat well
  • Get physical activity
  • Safely inject insulin
  • Adjust dosage if needed

Track Your Blood Sugar

How to manage diabetes for a long and healthy life

Tracking your blood sugar can keep you on track. The Canadian Diabetes Association recommends that people using insulin test their blood sugar levels regularly. People with Type 2 diabetes who aren’t using insulin may also want to self-monitor their blood sugar levels. It’s easy to do this at home with a blood glucose monitor.

Eat Well and Exercise

You can manage diabetes and live a long, healthy life

Food choices, especially related to alcohol and sweets, can greatly affect blood sugar levels. This is why nutrition is so important for people with diabetes, especially Type 2. Exercise can also lower your blood sugar and help insulin work more effectively.

Work with Your Healthcare Professionals

The most important thing you can do to manage your diabetes is to form a partnership with your healthcare professionals, says Tumber. They can help you monitor your diabetes and teach you how to track sugar levels and inject insulin safely. Prevention is key when it comes to avoiding long-term complications.

It really is possible to live a long and healthy life with diabetes. It just takes some knowledge and care. The best weapon to managing this chronic condition is education. That’s why London Drugs has Certified Diabetes Educators at select locations to help you better understand this disease. These are pharmacists with national certification as diabetes experts.

These Certified Diabetes Educators can also assist you in a variety of languages, including Cantonese, Punjabi, Mandarin, and Korean, depending on location. Language shouldn’t be a barrier when it comes to understanding the steps you need to take to manage your health.

To learn more about diabetes and managing the condition, visit the London Drugs Health Library online or talk to a Certified Diabetes Educator at select London Drugs locations.

5 Reasons Your Pharmacist is Awesome

Everyone knows that your pharmacist is the expert in filling your prescriptions, but everyone may not know that they provide many other super helpful services as well. We’re celebrating World Pharmacists Day by shining a light on all of the ways your friendly, neighbourhood London Drugs pharmacist can help you maintain and improve your health.

1. They can give you your jabs

Getting immunized isn’t exactly fun, but pharmacists can take the sting out of it by making it easy and convenient. If you’re planning a trip overseas, your pharmacist can help you prepare by reviewing your immunization history, letting you know which vaccines you’ll need for your destination, administering them, and issuing you an International Certificate of Vaccination if you need it.

London Drugs’ Certified Injection Pharmacists are also able to administer influenza vaccinations, as well as the Zostavax vaccine for Shingles.

If you would like to get a vaccination at a London Drugs pharmacy, just ask for more information at the pharmacy counter.

2. They give great advice

Although sometimes necessary, getting in to see a doctor can be time-consuming and complicated. If you’re looking for quick advice about minor ailments or wellness, your pharmacist can be your first stop on the road to good health. You can meet with a London Drugs pharmacist one-on-one to get trusted health advice on anything from allergy relief, diabetes management, nutrition, cough and cold remedies, pain management, stomach health, and eye care. Here’s the best part–no appointment necessary!

3. They help with the kids

Becoming a new parent can be scary, especially if you think something is wrong with your precious little bundle. If you have questions about your child’s health, pharmacists are an accessible resource. They can recommend over-the-counter medications that are safe for your children and provide information on proper dosage to help you treat common baby health conditions such as diaper rash, eczema, cradle cap, constipation, pain and fever, rashes, teething and more. Pharmacists can also refer your child to a doctor or other health professional if they feel your little bundle of joy requires a closer look.

4. They can help you find out for sure

You can never be too careful with your health, and pharmacists make it easier to put your mind at ease. Health screenings are a great way to take control of your health, and London Drugs provides the following convenient screening services and clinics at most of our locations:

5. They care about the community

Pharmacists are not only healthcare professionals, they are caring members of the community that they serve.

For example, last year during the British Columbia wildfire crisis, they provided life-saving services in the affected communities. While London Drugs helped assemble essential supplies and support staff, London Drugs pharmacists assisted those affected by accessing medical histories and contacted insurance providers to ensure quick access to essential medications for people who had to evacuate their homes.

Do you have a great story about how your super-pharmacist saved the day? Share it with us in the comments or on Twitter! #ilovemypharmacist

Diabetes alert dogs to the rescue

Image_003Sophie Mullins of Paradise, Newfoundland, was diagnosed with type 1 diabetes when she became seriously ill at the age of 18 months. Her parents, Heidi Pavelka and Jamie Mullins, worried about her constantly, since her blood sugar can drop without warning, putting her at risk of hypoglycemia. “Sophie doesn’t feel her lows—she could have low blood sugar and be running around the house as if everything is normal,” says Pavelka. Their worries were alleviated thanks to a new addition to the family: a six-month-old black Labrador retriever named Peaches, a diabetes alert dog who has been trained over several years to detect Sophie’s low blood sugar levels and get help when she needs it. (Note: At six months the dog moves in with the patient’s family to begin the training process.)

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Sight unseen: tips and techniques for coping with vision loss

Image_001Diabetes is the leading cause of blindness in Canada. Diabetic retinopathy, which results in vision loss, is caused by damage to the blood vessels of the retina. It affects 25% of people with type 1 diabetes and up to 14% of people with type 2 diabetes. Having diabetes also raises the risk of developing other eye problems, such as cataracts and glaucoma. While it can be frightening to lose part or all of your vision, there are plenty of strategies, tools, and resources available to help you stay as independent as possible. Here are some of them.

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Prescription for exercise

Image_001Physical activity is the best treatment for type 2 diabetes. Why not do it in the great outdoors?

Exercise is considered one of the cornerstones of treatment for people living with type 2 diabetes for a host of reasons: it improves the body’s use of insulin, burns excess body fat, improves muscle strength and heart health, increases bone density, lowers blood pressure, relieves stress, lifts one’s mood, and increases energy.

Exercise doesn’t just make you feel better, it also reduces disease, lessens hospitalizations, and can actually help you live longer. A 2012 study of 650,000 people from the U.S.-based Brigham and Women’s Hospital and the National Cancer Institute proved just that. It found that people over 40 who walked briskly for 75 minutes per week lived an extra 1.8 years. That increased to 3.4 years when they walked 150 to 299 minutes per week and to 4.5 years for 450 minutes per week.

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Is your child at risk for type 2 diabetes?

LD.diabAn alarming number of children are being diagnosed with type 2 diabetes. A generation ago it was rare to hear about a child having type 2 diabetes—it used to be only adults who got this disease.  Not anymore.  Over the past 15 years, there has been a 10- to 30-fold increase in American children with type 2 diabetes, due in great part to higher rates of obesity and lower rates of physical exercise among children.  Most of the affected children and youth are between the ages of 10 and 19, and more girls are affected than boys.  Most are also from ethnic groups at high risk for the disease, such as those of African, Hispanic, and Asian descent.  Type 2 diabetes is being diagnosed in Canadian First Nations children as young as eight years of age, and the incidence in this group is increasing rapidly.  In the next generation, it is estimated that the global incidence of type 2 diabetes in kids will increase by a whopping 50%.

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