With eleven million Canadians living with prediabetes or diabetes, the importance of screening, identifying, and managing individuals with diabetes is of epidemic importance. The appropriate management of diabetes cannot be understated. If left untreated, it can lead to complications including heart disease, stroke, and kidney damage. Further, nerve damage and poor blood flow can result in increased risk for foot conditions as well as ocular changes affecting vision and eye health.
“My pharmacist asked me questions to help us figure out what might be causing these seemingly random ups and downs in my day to day blood sugars.”
The role of pharmacists
Pharmacists play an important role in the management of diabetes, helping Albertans to manage their medication regime, monitor important laboratory parameters, and support healthy living and lifestyle choices. Using convenient point of care testing, pharmacists help to screen Albertans at risk for diabetes. Your pharmacist can prescribe changes to your diabetic medications, order important lab tests and review the results with you, and administer drugs and vaccines by injection when required. Working together with you, your pharmacist will review your medical history and work collaboratively to create a plan to care for your diabetes in a way that will help you to lead a high functioning, healthy and productive life.
A Patient Story
My name is Fred. I have lived with diabetes for many years now. One of my greatest frustrations with diabetes is that it is a medical condition that can get a little worse as time goes by. When I was first diagnosed with diabetes, my doctor started me on one medication that I had to take twice a day. It worked well for the first couple of years, but eventually using just one medication wasn’t enough to keep my blood sugar levels normal anymore.
Now I take three different medications and I was started on insulin injections about three years ago. One day my pharmacist asked me if I would be interested in having her provide a “care plan” for me. We sat down together and talked about all the medications I take, how I take them, and what they are supposed to do for me.
Part of managing my diabetes requires me to test my blood sugar quite regularly. I do this with a home blood sugar meter that my pharmacist helped select for me. I like to test my blood sugar every morning using my home blood sugar meter. Sometimes I also test before and after I eat and at bedtime too. The pharmacist used these readings as well as my lab results to show me how my blood sugars seemed to be a little higher than they were supposed to be. On the days when I would wake up in the morning with a high blood sugar reading, it would stay high all day. On the days when I woke up to a normal blood sugar reading, my readings would be good for the rest of the day.
My pharmacist asked me questions to help us figure out what might be causing these seemingly random ups and downs in my day to day blood sugars. I told her nothing I do seems to make a difference. On the days when my levels are high I don’t “do” anything different. I eat three meals a day. I try to walk every day. I told her I take my medication the same time every day because I know how important it is for me to keep my sugars down to reduce my risk of having a heart attack or stroke, or of developing problems with my nerves, circulation, kidneys and eyes. Then she asked me to show her how I administer my insulin each night. That is when she figured out what needed to change!
She told me my insulin injection technique was good except for one thing – I was not changing my injection sites often enough. I was using two small areas on my stomach, one on the left and one on the right. The pharmacist explained to me that when insulin is injected into the same spot more than once every four weeks, it can develop lumps under the skin that will affect how my insulin works in my body. She told me that any insulin injected in or around one of these “lumpy” sites would cause my blood sugar readings in the morning to be higher than if I injected somewhere else.
Sure enough, when she checked my stomach I had two big lumps and a couple of smaller ones right where I always like to inject my insulin. The pharmacist helped me come up with a plan to rotate the spots on my body where I inject my insulin so that I can avoid creating any lumpy areas. Within a matter of days, all of my blood sugar levels had come back down to normal levels! Because my pharmacist took the time to understand how I was using my insulin, we were able to make one small change that has made a huge impact in my life and how I continue to live with diabetes. I can’t thank her enough.