Monday, March 15, 2021

• Diabetes (Blood Sugar)

Diabetes (Blood Sugar)
Normal Glucose Level (65 - 99)
Ask your doctors:
Janumet XR (50-1,000mg) tablets --- for Blood Sugar (Stroke, Blind)
(Glucose Level >126)/(A1C > 6.4) - Take 1 tablet in the morning
@ Taking JANUMET XR [50-1,000 mg], You Must Take Vitamin B12 Methylcobalamin
* sam's club: Vitamin B12 Methylcobalamin 5,000 mcg! (1/day - 300ct - $18.98)
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Diabetes (Blood Sugar)
When to Call the Doctor 
Low: [< 54 mg/dL]
High: remains [> 240 mg/dL]

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A1C At-Home Testing Kits Can Help You Monitor Your Blood Sugar

If you have diabetes, you probably already use a glucometer, which allows you to check your blood sugar at home. Just like there are at-home blood sugar testing devices, there are also at-home devices to check your hemoglobin A1C. Your hemoglobin A1C gives you and your health provider a better idea of your average blood sugar level over a two to three month period.



@ A1C Test for Diabetes, Animation

A1C and Estimated Average Glucose Levels

Normal (4.8 - 5.6)

If your blood glucose is in mg/dL (for those living in the US), use this formula:
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A1C% = [46.7 + averageBG(mg/dl)] / 28.7
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A1CNow Systems - A1CNow® Self Check System with 4 Test Strips (Part #HM53537) - $52.95

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1. Tingling and Numbness
2. Skin Changes
3. Nerve Problems
4. Excess Abdominal Weight/Fat
5. Always Hungry
6. Dry and Itchy Skin
7. Thirst
8. Constant Fatigue, or Extreme Tiredness
9. Stomach Problems
10. Slow Healing Wounds
11. Recurrent Infection
12. Impotence
13. Dry Mouth
14. Difficulty Concentrating
15. Blurred Vision
16. Excessive Urination, Urinating during the Night (more than 7 times/day)
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When your blood sugar level gets too high — known as hyperglycemia or high blood glucose — the quickest way to reduce it is to take fast-acting insulin. Exercising is another fast, effective way to lower blood sugar.
In some cases, you should go to the hospital instead of handling it at home.
Very high blood sugar levels can result in diabetic ketoacidosis (DKA) when insulin levels are low. This is a medical emergency.
Symptoms of DKA include:
1. shortness of breath
2. breath that smells fruity
3. nausea and vomiting
4. a very dry mouth
If you aren’t sure what to do, call your doctor to get instructions on administering a dose of insulin, and for advice about whether to go to the emergency room.
This article looks at ways to lower your blood sugar quickly, when to go to the emergency room or see a doctor, and tips for managing high blood sugar.
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1. Increased swelling of legs, or feet
2. Skin color changes
3. Burning, tingling, numbness, or a lack of feeling in the feet, or toes
4. Sores, cuts or bruises that heal more slowly than usual.
5. Cracks in the skin between the toes.
6. Appearance of blisters, bunions, planter warts, corns and calluses.
7. Athlete's foot.
8. Hair loss on toes, or legs.
9. Ingrown toenais.

1. Loss of Sensation
2. Reduced Blood Circulation
3. Pain and Pricking Sensation
4. Burning Sensation
5. Itching for No Reason
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@ Evaluation and Management of Diabetes-Related Foot Complications




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@ Taking JANUMET XR [50-1,000 mg], You Must Take Vitamin B12! (1/day)
Generic Name: SITAGLIPTIN/metFORMIN EXRENDED-RELEASE-ORAL - First Databank, Inc
Color: Light Green
Shape: Oval

Janumet XR (50-1,000mg) (60 tablets) --- for Blood Sugar (Stroke, Blind) --- Take 1 tablet in the Morning
metFORMIN; SITAGLIPTIN is a combination of 2 medicines used to treat type 2 diabetes. This medicine lowers blood sugar. Treatment is combined with a balanced diet and exercise. The lowest GoodRx price for the most common version of Janumet XR is around $455.09, 18% off the average retail price of $557.83. Compare gliptin / biguanide combinations. 1 tablet (in the morning) daily with meals

Medical Editor: John P. Cunha, DO, FACOEP
Last reviewed on RxList 7/30/2019

Janumet XR (sitagliptin and metformin HCl) Extended-release Tablets contains two oral antidiabetic medications indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus when treatment with both sitagliptin and metformin extended-release is appropriate. Janumet XR should not be used in patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis. Common side effects of Janumet XR include:

    1. stuffy or runny nose,
    2. sore throat,
    3. upper respiratory infection,
    4. diarrhea,
    5. nausea,
    6. vomiting,
    7. gas,
    8. stomach discomfort,
    9. abdominal pain,
    10. indigestion,
    11. weakness,
    12. headache,
    13. swelling of extremities, and
    14. low blood sugar (hypoglycemia) when used in combination with certain medications, such as a sulfonylurea or insulin.

Tell your doctor if you experience symptoms of hypoglycemia including:
    1. sweating,
    2. shaking,
    3. fast heartbeat,
    4. hunger,
    5. blurred vision,
    6. dizziness, or
    7. tingling in the hands or feet.

* Janumet (sitagliptin / metformin) [50-1,000 mg] used for Type 2 diabetes
Janumet (sitagliptin / metformin) is a combination medication containing sitagliptin and metformin. This medication is an add-on to diet and exercise to improve blood sugar control in people with type 2 diabetes. Janumet (sitagliptin / metformin) is a combination of 2 different diabetic medications. Metformin, a biguanide, works by lowering the amount of sugar your liver releases into your blood and helps your body respond better to insulin. Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, works by increasing the amount of insulin your body makes.

The typical dose is 1 tablet (50 mg sitagliptin and 1000 mg of metformin) twice daily with meals. For the extended release (XR) version, the typical dose is 1 tablet daily with meals.

Janumet and Janumet XR are both prescription medications designed to be used along with diet and exercise to help control blood sugar levels in adults with type 2 diabetes. 
The difference is that 
* Janumet is taken twice daily, while 
* Janumet XR (extended-release) is taken only once daily.

Medical Editor: John P. Cunha, DO, FACOEP

What Is Janumet?
Janumet (sitagliptin/metformin HCl) is a combination of oral diabetes medicines for people with type 2 diabetes who do not use daily insulin injections. Janumet is not for treating type 1 diabetes.
Common side effects of Janumet include:

    1. nausea,
    2. vomiting,
    3. stomach upset,
    4. diarrhea,
    5. constipation,
    6. headache,
    7. weakness,
    8. back pain,
    9. joint or muscle pain,
    10. a metallic taste in the mouth, or
    11. cold symptoms such as runny or stuffy nose, sneezing, and sore throat.

Janumet does not usually cause low blood sugar (hypoglycemia). Low blood sugar may occur if Janumet is prescribed with other anti-diabetic medications. Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. 
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How to Use Onetouch Verio Reflect
You qualify for a free OneTouch Verio® brand meter
UnExpected Reading, or Accidently Drop the meter - USE Control Solution
* Level 3 - (102 mg/dL - 138 mg/dL), or
* Level 4 - (298 mg/dL - 403 mg/dL)
* Walmart: OneTouch Verio Test Strips, Accuracy You Can Trust, 50 Each - $25.95 ($0.52/ea)
* Walmart: OneTouch Verio Diabetes Test Strips Value Pack - 30 Count (2 Pack) - $39.99 ($0.67/ea)
* OneTouch Verio Reflect 50 test strips - $40.99 ($0.82/ea)

* ONETOUCH Verio Reflect Blood Glucose Meter - Blood Sugar Monitor (LifeScan - Johnson & Johnson US Company) - $29.99
* OneTouch Verio Reflect Meter -  (LifeScan - Johnson & Johnson US Company) - $28.99
* OneTouch Verio Blood Glucose Test Strips, 25 Ct. Exp. 05/2022 - $18.80
* OneTouch Ultra2 Blood Glucose Monitoring System (LifeScan - Johnson & Johnson US Company) - $26.99
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PRODUCT DESCRIPTION
The TRUE METRIX Glucose Meter by Trividia Health is a reliable monitor for quick and accurate blood glucose testing. The TRUE METRIX meter kit tests blood sugar from the fingertip or forearm and is able to store 500 results with the date and time.

TRUE METRIX Meter Features:
- Alternate site testing
- Data storage
- Testing reminders
- Audible fill detection
- Release test strip button
- Event tagging
- 7, 14, 30 day averaging

Includes:
- True Metrix Self Monitoring Blood Glucose Meter
- Installed 3 Volt Battery
- Instructions For Use (Read before use)
- Self Test Log Book
- Compact Carrying Case
- 100 True Metrix Self Monitoring Glucose Test Strips
- DISCLAIMER: This TRUE METRIX meter kit does NOT come with a lancing device or lancets.

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@ 50Blood Glucose Test Blood Glucose Monitor Test Strips Fit GUC1 Health Tool #S03 (New) - US $17.95 ($0.40/ea)
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* Sinocare Safe UG Blood Glucose and Uric Acid Bi-Functional Device Demonstration
Code Chip - (Memory: 100 Glucose + 100 UA records)
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Blood Sugar Levels Chart: fasting and after eating

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Blood Sugar (100-125 [Pre-Diabetic]), ask your doctor: metFORMIN HCL 500mg

(Metformin) Metformin is used with a proper diet and exercise program and possibly with other medications to control high blood sugar. It is used in patients with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Metformin works by helping to restore your body's proper response to the insulin you naturally produce. It also decreases the amount of sugar that your liver makes and that your stomach/intestines absorb.
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Metformin is a prescription drug used to treat type 2 diabetes. It belongs to a class of medications called biguanides. People with type 2 diabetes have blood sugar (glucose) levels that rise higher than normal. Metformin doesn’t cure diabetes. Instead, it helps lower your blood sugar levels to a safe range.

Metformin causes some common side effects. These can occur when you first start taking metformin, but usually go away over time. Tell your doctor if any of these symptoms are severe or cause a problem for you.
The more common side effects of metformin include:
2. stomach pain
4. bloating
5. gas
6. diarrhea
7. constipation
8. weight loss
9. headache
10. unpleasant metallic taste in mouth

Nausea, vomiting, and diarrhea are some of the most common side effects people have when they first start taking metformin. These problems usually go away over time. You can reduce these effects by taking metformin with a meal. Also, to help lessen your risk of severe diarrhea, your doctor will likely start you on a low dosage of metformin and then increase it slowly.

Metformin is sometimes used to prevent diabetes in women with polycystic ovarian disease (PCOS). It’s used off-label for this purpose. The side effects for this use are the same as for other uses.

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******* Low Blood Sugar [<70 mg/dL] ******
Low blood sugar is called hypoglycemia. A blood sugar level below 70 mg/dL (3.9 mmol/L) is low and can harm you. A blood sugar level below 54 mg/dL (3.0 mmol/L) is a cause for immediate action.

You are at risk for low blood sugar if you have diabetes and are taking any of the following diabetes medicines:
* Insulin
* Glyburide (Micronase), glipizide (Glucotrol), glimepiride (Amaryl), repaglinide (Prandin), or nateglinide (Starlix)
* Chlorpropamide (Diabinese), tolazamide (Tolinase), acetohexamide (Dymelor), or tolbutamide (Orinase)
You are also at increased risk of having low blood sugar if you have had previous low blood sugar levels.

Recognizing Low Blood Sugar
Know how to tell when your blood sugar is getting low. Symptoms include:
1. Weakness or feeling tired
2. Shaking
3. Sweating
4. Headache
5. Hunger
6. Feeling uneasy, nervous, or anxious
7. Feeling cranky
8. Trouble thinking clearly
9. Double or blurry vision
10. Fast or pounding heartbeat

Sometimes your blood sugar may be too low even if you do not have symptoms. If it gets too low, you may:
1. Faint
2. Have a seizure
3. Go into a coma
Some people who have had diabetes for a long time stop being able to sense low blood sugar. This is called hypoglycemic unawareness. Ask your health care provider if wearing a continuous glucose monitor and sensor can help you detect when your blood sugar is getting too low in order to help prevent symptoms.

Preventing Low Blood Sugar [< 70 mg/dL]
Preventing low blood sugar is better than having to treat it. Always have a source of fast-acting sugar with you.

When you exercise, check your blood sugar levels. Make sure you have snacks with you. Talk to your provider about reducing insulin doses on days that you exercise.
Ask your provider if you need a bedtime snack to prevent low blood sugar overnight. Protein snacks may be best.

DO NOT drink alcohol without eating food. Women should limit alcohol to 1 drink a day and men should limit alcohol to 2 drinks a day. Family and friends should know how to help. They should know:

The symptoms of low blood sugar and how to tell if you have them. How much and what kind of food they should give you.

When to call for emergency help.
How to inject glucagon, a hormone that increases your blood sugar. Your provider will tell you when to use this medicine. If you have diabetes, always wear a medical alert bracelet or necklace. This helps emergency medical workers know you have diabetes.

When Your Blood Sugar Gets Low [< 70 mg/dL]
Check your blood sugar whenever you have symptoms of low blood sugar. If your blood sugar is below 70 mg/dL, treat yourself right away.
1. Eat something that has about 15 grams (g) of carbohydrates. Examples are:
* 3 glucose tablets
* One half cup (4 ounces or 237 mL) of fruit juice or regular, non-diet soda
* 5 or 6 hard candies
* 1 tablespoon (tbsp) or 15 mL of sugar, plain or dissolved in water
* 1 tbsp (15 mL) of honey or syrup

2. Wait about 15 minutes before eating any more. Be careful not to eat too much. This can cause high blood sugar and weight gain.
3. Check your blood sugar again.
4. If you do not feel better in 15 minutes and your blood sugar is still lower than 70 mg/dL (3.9 mmol/L), eat another snack with 15 g of carbohydrates.

You may need to eat a snack with carbohydrates and protein if your blood sugar is in a safer range -- over 70 mg/dL (3.9 mmol/L) -- and your next meal is more than an hour away.
Ask your provider how to manage this situation. If these steps for raising your blood sugar do not work, call your doctor right away.

When to Call the Doctor [< 54 mg/dL]
If signs of low blood sugar do not improve after you have eaten a snack that contains sugar, have someone drive you to the emergency room or call your local emergency number (such as 911). DO NOT drive when your blood sugar is low.
Get medical help right away for a person with low blood sugar if the person is not alert or cannot be woken up.



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