Frequently Asked Questions

Frequently Asked Questions:

About Diabetes:

· What is diabetes?

· What causes diabetes?

· How do I know if I have diabetes?

· What is pre-diabetes?

· What are the different types of diabetes?

Taking Care of My Diabetes?

· What are the long-term complications of diabetes?

· Can I double the dose if I feel the medication is not working?

· Do I need a new lancet each time?

· Do I need to rotate the site of insulin injection?

· Do I need a prescription for my insulin and supplies?

· When is the best time for me to check my blood sugar? How often should I check my blood sugar?

· What are the symptoms of low blood sugar? How is it treated?

· My doctor increased my dosage. Do I need a new prescription for that?

· What is the difference in each of the glucometers on the market?

· Which drugs will affect my blood sugar levels?

· If I have diabetes, should I purchase sugar-free cough syrup rather than regular cough syrup?

How do I pay for it?

· If I can’t afford the medication, is there another alternative?

· I have Medicare. Will it pay for diabetic supplies?

· I have Medicaid. Will it pay for diabetic supplies?

· Which insurance covers diabetic supplies?

Local Resources:

· How can I get a ride to my doctor?

· Who provides diabetes education classes in Harnett County?

· Where can I get diabetic shoes?

Question: What is diabetes?

Answer: Diabetes is characterized by high blood glucose (sugar) levels. The high glucose levels are the result of the body not producing enough insulin, inability of the body to use insulin, or a combination of the two. The high blood glucose levels can lead to many complications. For more information, click here. (http://www.diabetes.org/about-diabetes.jsp)

Question: What causes diabetes?

Answer: It is not known completely what causes diabetes. It appears that both genetics (family history) and environmental factors (obesity, inactivity) play a role in the development of diabetes. If you have a family history of diabetes, there is a good chance you may have the gene for diabetes. Stress, sickness, lack of exercise, and being overweight can all trigger your diabetes to show up earlier in life.

Question: How do I know if I have diabetes?

Answer: Some of the most common symptoms of diabetes include excessive thirst, frequent urination, excessive hunger, fatigue, irritability, and blurry vision. If you have these symptoms, check with your doctor. There are several ways your doctor can diagnose diabetes. Your doctor can perform a fasting plasma glucose test or an oral glucose tolerance test to determine if you have diabetes or pre-diabetes. A fasting plasma glucose test is when your glucose is checked by your doctor before you have had anything to eat or drink for at least 8 hours. It is usually performed first thing in the morning. If your doctor conducts the fasting plasma glucose test, a glucose level of greater than or equal to 126 mg/dl is considered diabetes, while a glucose level between 100 and 125 mg/dl is considered pre-diabetes. An oral glucose tolerance test is when your doctor has you drink a special liquid and then tests your blood sugar every hour for 3 hours. If your doctor conducts an oral glucose tolerance test, a two-hour glucose level of greater than or equal to 200 mg/dl is considered diabetes, while a glucose level between 140 and 199 mg/dl is considered pre-diabetes. For more information, click here. (http://www.diabetes.org/diabetes-symptoms.jsp)

Question: What is pre-diabetes?

Answer: Pre-diabetes is the same as impaired glucose tolerance or impaired fasting glucose, depending on which test your doctor used to diagnose the disease. Many people with pre-diabetes go on to develop type 2 diabetes. If your doctor diagnoses you with pre-diabetes, you are in a good position. This means you have the opportunity to use weight loss from diet and exercise to prevent developing diabetes. For more information, click here. (http://www.diabetes.org/pre-diabetes.jsp)

Question: What are the different types of diabetes?

Answer: The most common types of diabetes are Type 1, Type 2, and Gestational diabetes. Type 1 diabetes results when the body does not make any insulin because the body’s immune system destroys the cells in the body that make insulin. It is often diagnosed in childhood, although it can occur at any age. Patients with Type 1 diabetes must use insulin injections to control their diabetes. For more information on Type 1 diabetes, click here. (http://www.diabetes.org/type-1-diabetes.jsp) Type 2 diabetes results when the body does not make enough insulin and/or the insulin is not properly used by the body (insulin resistance). Type 2 diabetes is often diagnosed in adults, though there is an increasing number of teenagers being diagnosed, and is the most common type of diabetes, accounting for about 90-95% of all cases of diabetes. It is often associated with older age, obesity and/or physical inactivity, a family history of diabetes, a history of gestational diabetes, and impaired glucose tolerance. Type 2 diabetes is also more common in African Americans, Hispanic/Latino Americans, Native Americans, some Asian Americans, Native Hawaiian, and Pacific Islanders. For more information on Type 2 diabetes, click here. (http://www.diabetes.org/type-2-diabetes.jsp) Gestational diabetes results when diabetes develops during pregnancy. It must be treated to avoid complications in the infant. Many women with gestational diabetes go on to develop Type 2 diabetes. For more information on Gestational diabetes, click here. (http://www.diabetes.org/gestational-diabetes.jsp)

Question: What are the long-term complications of diabetes?

Answer: Uncontrolled diabetes can lead to many complications in other parts of your body. The most common organs affected by diabetes include your heart, eyes, stomach, and kidneys. Diabetes is associated with an increased risk of heart disease, heart attacks, and stroke. For more information on the association of diabetes with heart disease and stroke, click here. (http://www.diabetes.org/diabetes-heart-disease-stroke.jsp) Diabetes is also a leading cause of blindness. For more information on the association of diabetes with eye conditions, click here. (http://www.doh.state.fl.us/family/dcp/whatis/eye.html) Diabetes is associated with nerve damage, particularly of the legs and gastrointestinal tract. This can lead to a loss of sensation and a burning and tingling sensation of your legs, as well as chronic constipation or diarrhea. Diabetes is also a leading cause of kidney damage. For more information about diabetes and your kidneys, click here. (http://www.doh.state.fl.us/family/dcp/whatis/nephropathy.html) Diabetes is also associated with amputations of the foot or leg. Be sure to see your doctor at the first sign of a foot infection. Signs of a foot infection begin with a reddened area, followed by open sores (ulcers) which may quickly develop into oozing, foul-smelling area(s). Check your feet daily for signs of infection. If you haven an area that is only red, keep a check on the area daily and notify your doctor if it worsens. If the area on the foot is an open sore, contact your doctor immediately. Though the complications of diabetes is a harsh reality, by keeping your diabetes under good control and early intervention by your doctor, you can decrease your chance of developing these complications and others.

Question: Can I double the dose if I feel the medication is not working?
Answer: No. Do not double the dose of your medication if you feel it is not working. Some diabetes medications can take several weeks to see the full effect. Doubling the dose of your medication can increase the risk for side effects and adverse reactions.

Question: Do I need a new lancet each time?
Answer: A lancet is the name for the needle that pricks your skin when you are checking your blood sugar. You should use a new lancet each time you check your blood sugar. Using the same lancet several times increases your chances of developing an infection. Also, if the lancet is used more than once, it becomes dull, which can make testing your blood sugar more painful.

Question: Do I need to rotate the site of insulin injection?
Answer: Yes. Insulin injections should be rotated to avoid the development of lumps or scar tissue. Since the absorption of insulin can vary depending on which area of the body you inject, you should inject in the same general area, but not the exact location. Insulin should be injected into the fat layer below the skin. The abdomen (at least 2 inches away from the belly button), upper thighs, and backs of the upper arms can all be used when injecting your insulin. Talk to your doctor about which area of the body is best for you to use when injecting your insulin.

Question: Do I need a prescription for my insulin and supplies?
Answer: Some types of insulin require a prescription while others do not. The newer rapid-acting insulins, such as Humalog, and the long-acting insulin, Lantus, require prescriptions. Some states require prescriptions for needles and syringes. North Carolina does not require a prescription for needles and syringes, unless your insurance pays for the supplies.

Question: When is the best time for me to check my blood sugar? How often should I check my blood sugar?

Answer: The best time to check your blood sugar depends on several factors, including the types of diabetes medications or insulin you are taking, and how controlled your diabetes is. Talk to your doctor about the best time to check your blood sugar.

Question: What are the symptoms of low blood sugar? How is it treated?

Answer: Low blood sugar is called hypoglycemia. The most common symptoms of hypoglycemia include: shakiness, dizziness, sweating, fast heartbeat, sudden hunger, headache, pale skin, irritability, and difficulty concentrating. Some people may also experience a tingling sensation around the mouth, clumsy movements, or seizures. If you experience hypoglycemia, it is important to treat it immediately. You can increase your blood sugar by eating 3 glucose tablets (which you can buy from a drug store), drinking a half cup of fruit juice (4 ounces), or chewing several pieces of hard candy. If you choose hard candy, you must chew the candy rather than suck the candy to help your body receive the sugar quickly. Avoid using chocolate to treat a low blood sugar. Chocolate contains a large amount of fat, which slows down how quickly your body is able to use the sugar. After treating a low blood sugar, it is important to recheck your blood sugar after 15-20 minutes to make sure your blood sugar is going up. If it is still low, repeat the treatment. Once you begin to feel better, it is important to eat your regular meal or a snack to prevent your blood sugar from getting too low again. Your doctor can help you develop a plan to prevent and treat hypoglycemia.

Question: My doctor increased my dosage. Do I need a new prescription for that?

Answer: It is a good idea to get a new prescription from your doctor any time your dosage changes.

Question: What is the difference in each of the glucometers on the market?

Answer: There are many different kinds of glucometers available. Some require a large drop of blood that is dropped onto the test strip, while others require a small drop of blood that is pulled into the test strip by capillary action (a “sucking” motion). Some glucometers allow for alternate site testing (testing places other than your fingers, such as your forearm, thigh, or palm of hand), while others only allow for fingerstick testing. Glucometers can have many “bells and whistles” such as alarms and downloading ability, or can be very basic. Many glucometers need to be calibrated with each box of test strips, but some newer glucometers do not require calibration. You have the choice as to how many features you want your glucometer to have. You should talk with your doctor or pharmacist to determine which glucometer would be the best for your needs.

Question: Which drugs will affect my blood sugar levels?

Answer: Many drugs, both prescription and over-the-counter products, can interfere with your diabetes control. Some drugs can increase your blood sugar, while others can lower your blood sugar too much. If you take certain types of blood pressure medications, you may not notice symptoms of a low blood sugar, except for sweating. If you take medication for high blood pressure, discuss this with your doctor. Finally, some medications can interfere with the diabetes medications themselves and lead to more side effects or adverse reactions. Anytime you start a new medication, make sure your doctor and pharmacist know all the other medications you are taking (including over-the-counter products) so they can check for interactions. Anytime you have a question about your medications, ask your doctor or pharmacist.

Question: If I have diabetes, should I purchase sugar-free cough syrup rather than regular cough syrup?

Answer: Not necessarily. It depends on how well controlled your sugar is. If your sugar is very controlled, the amount of sugar in the recommended dose of cough syrup will not be enough to increase your blood sugar significantly. However, if your blood sugar is not very well controlled, you should consider the purchase of sugar-free cough syrup or discuss the use of regular cough syrup with your doctor. Also, keep in mind that sugar-free syrup does not taste very good. If you do use sugar-free cough syrup, you can make it taste better by keeping it in the refrigerator.

Question: I have Medicare. Will it pay for diabetic supplies?

Answer: Medicare Part B and Medicare managed care policies do cover certain diabetes supplies. A doctor must write a prescription for the supplies and renew it every six months. Patients are eligible to receive a glucometer, test strips, lancets, lancet devices, and control solutions. There are restrictions as to how many test strips and lancets you are allowed a month, depending on whether or not you use insulin. Patients using insulin can get up to 100 test strips and lancets per month, while patients not using insulin can get up to 100 test strips and lancets every 3 months. Exceptions can be made with proper documentation by your doctor.

Question: I have Medicaid. Will it pay for diabetic supplies?
Answer: All enrollees with diabetes are eligible for coverage of blood sugar monitors and test strips, including both those who use insulin and those who do not. Pregnant women with gestational diabetes can also receive coverage of testing supplies. Medicaid also pays for insulin syringes if you need them. You will need prescriptions from your doctor. The number of test strips covered each month is limited. Also, you will need to find a pharmacy that is registered with a special section of Medicaid and is eligible to bill Medicaid for supplies. By using a Medicaid registered pharmacy, you will receive coverage for both test strips and insulin syringes.

Question: Which insurance covers diabetic supplies?

Answer: Each insurance plan is different. It is recommended that you contact your insurance company or check your policy to see if diabetic supplies are covered.

Question: If I can’t afford the medication, is there another alternative?
Answer: Some pharmaceutical companies offer programs that provide free or reduced cost medications to patients without prescription insurance. Your doctor will need to fill out paperwork from the pharmaceutical company and you will need to provide documentation of your income. Have your doctor or pharmacist contact the pharmaceutical company that makes your medications in order to obtain the appropriate application materials.

Not all medications have a prescription assistance program offered by the pharmaceutical company. If this is the case, talk to your doctor about using generic medications rather than brand name medications. It is also worth comparing prices at several pharmacies.

Question: How can I get a ride to my doctor?

Answer: In Harnett County, patients can receive transportation to their doctor’s through the HARTS transportation system for Harnett County. To receive additional information regarding this service click here.

Question: Who provides diabetes education classes in Harnett County?

Answer: In Harnett County, Betsy Johnson Regional Hospital provides a diabetes education course titled, “Living with Diabetes”. This 12-hour course has been approved the American Diabetes Association. To be involved in this course, patients must be referred by their physician. Click here for additional information.

Question: Where can I get diabetic shoes?

Answer: In Harnett County, you can get diabetic shoes at Family Medical Supply, Lee’s Shoe Store, and McPhail’s Pharmacy. For contact information click here.