Whether you use food exchanges or carbohydrate counting, McDonald's provides nutrition information to help you with your diabetes meal planning. Consider these. Diabetes doesn't have to stop you from enjoying life's pleasures. And that includes dining out. You can eat out and still stay on your meal plan. Here are some. Monitor the amount of carbohydrates eaten at each meal and snack. • Eating large amounts of low GI foods can still make blood glucose levels too high. •. BTC ROBOT LEGIT

Rapid-acting insulin can be mixed with NPH, lente, and ultralente. When rapid-acting insulin is mixed with either an intermediate- or long-acting insulin, the mixture should be injected within 15 min before a meal. Mixing of short-acting and lente insulins is not recommended except for patients already adequately controlled on such a mixture.

If short-acting and lente mixtures are to be used, the patient should standardize the interval between mixing and injection. Insulin formulations may change; therefore, the manufacturer should be consulted in cases where its recommendations appear to conflict with the American Diabetes Association guidelines. There may be differences in the way units are indicated, depending on the size of the syringe and the manufacturer. Insulin syringes are manufactured with 0. Several lengths of needles are available.

Blood glucose should be monitored when changing from one length to another to assess for variability of insulin absorption. Regulations governing the purchase of syringes vary greatly from one state to another. Many different medical devices have been developed to reduce the risk of needle sticks and other sharps injuries using current OSHA standards.

These devices incorporate features designed to reduce injury. Use of some currently available insulin syringes with engineered sharps injury protection ESIP may present barriers to effective insulin self-administration training. Individualized patient assessment should guide the use of an ESIP insulin syringe during insulin self-administration instruction.

Syringes must never be shared with another person because of the risk of acquiring a blood-borne viral infection e. Travelers should be aware that insulin is available in a strength of U outside of the U. To avoid dosing errors, syringes that match the concentration of U insulin must be used. Disposal Recapping, bending, or breaking a needle increases the risk of needle-stick injury and should be avoided.

Insulin syringes and pens, needles, and lancets should be disposed of according to local regulations. Some areas may have special needle disposal programs to prevent sharps from being in the main waste disposal stream. When community disposal programs are unavailable, used sharps should be placed in a puncture-resistant container.

Local trash authorities should be contacted for proper disposal of filled containers. Care should be taken to keep these filled containers away from containers to be recycled. In areas with container-recycling programs, placement of containers of used syringes, needles, and lancets with materials to be recycled is prohibited. Needle reuse Manufacturers of disposable syringes and pen needles recommend that they only be used once.

One potential issue, which arises with reuse of syringes or needles, is the inability to guarantee sterility. Most insulin preparations have bacteriostatic additives that inhibit growth of bacteria commonly found on the skin. Patients with poor personal hygiene, an acute concurrent illness, open wounds on the hands, or decreased resistance to infection for any reason should not reuse a syringe or pen needle.

Another issue has arisen with the advent of newer, smaller 30 and 31 gauge needles. Even with one injection, the needle tip can become bent to form a hook which can lacerate tissue or break off to leave needle fragments within the skin. The medical consequences of these findings are unknown but may increase lipodystrophy or have other adverse effects.

Some patients find it practical to reuse needles. Certainly, a needle should be discarded if it is noticeably dull or deformed or if it has come into contact with any surface other than skin. If needle reuse is planned, the needle must be recapped after each use. Patients reusing needles should inspect injection sites for redness or swelling and should consult their healthcare provider before initiating the practice and if signs of skin inflammation are detected.

Before syringe reuse is considered, it should be determined that the patient is capable of safely recapping a syringe. Proper recapping requires adequate vision, manual dexterity, and no obvious tremor. The patient should be instructed in a recapping technique that supports the syringe in the hand and replaces the cap with a straight motion of the thumb and forefinger.

The technique of guiding both the needle and cap to meet in midair should be discouraged, because this frequently results in needle-stick injury. The syringe being reused may be stored at room temperature. The potential benefits or risks, if any, of refrigerating the syringe in use or of using alcohol to cleanse the needle of a syringe are unknown. Cleansing the needle with alcohol may not be desirable, because it may remove the silicon coating that makes for less painful skin puncture.

These injectors offer an advantage for patients unable to use syringes or those with needle phobias. A potential advantage may be a more rapid absorption of short-acting insulin. However, the initial cost of these injectors is relatively high, and they may traumatize the skin. They should not be viewed as a routine option for use in patients with diabetes. Several pen-like devices and insulin-containing cartridges are available that deliver insulin subcutaneously through a needle.

In many patients e. Low-dose pens that can deliver insulin in half-unit increments are also available. Insulin delivery aids e. The hands and the injection site should be clean. For all insulin preparations, except rapid- and short-acting insulin and insulin glargine, the vial or pen should be gently rolled in the palms of the hands or shaken gently to resuspend the insulin.

An amount of air equal to the dose of insulin required should first be drawn up and injected into the vial to avoid creating a vacuum. For a mixed dose, putting sufficient air into both bottles before drawing up the dose is important. When mixing rapid- or short-acting insulin with intermediate- or long-acting insulin, the clear rapid- or short-acting insulin should be drawn into the syringe first.

After the insulin is drawn into the syringe, the fluid should be inspected for air bubbles. One or two quick flicks of the forefinger against the upright syringe should allow the bubbles to escape. Air bubbles themselves are not dangerous but can cause the injected dose to be decreased.

Injection procedures Injections are made into the subcutaneous tissue. Routine aspiration drawing back on the injected syringe to check for blood is not necessary. Particularly with the use of insulin pens, the needle should be embedded within the skin for 5 s after complete depression of the plunger to ensure complete delivery of the insulin dose.

Patients should be aware that air bubbles in an insulin pen can reduce the rate of insulin flow from the pen; underdelivery of insulin can occur when air bubbles are present, even if the needle remains under the skin for as long as 10 s after depressing the plunger. Air can enter the insulin pen reservoir during either manufacture or filling if the needle is left on the pen between injections.

To prevent this potential problem, avoid leaving a needle on a pen between injections and prime the needle with 2 units of insulin before injection. If an injection seems especially painful or if blood or clear fluid is seen after withdrawing the needle, the patient should apply pressure for 5—8 s without rubbing.

Blood glucose monitoring should be done more frequently on a day when this occurs. If the patient suspects that a significant portion of the insulin dose was not administered, blood glucose should be checked within a few hours of the injection. Painful injections may be minimized by the following: Injecting insulin at room temperature.

Making sure no air bubbles remain in the syringe before injection. Waiting until topical alcohol if used has evaporated completely before injection. Keeping muscles in the injection area relaxed, not tense, when injecting. Penetrating the skin quickly. Not changing direction of the needle during insertion or withdrawal.

Not reusing needles. Some individuals may benefit from the use of prefilled syringes e. Prefilled syringes are stable for up to 30 days when kept in a refrigerator. If possible, the syringes should be stored with the needle pointing upward or laying flat, so that suspended insulin particles do not clog the needle.

The predrawn syringe should be rolled between the hands before administration. A quantity of syringes may be premixed and stored. The effect of premixing of insulins on glycemic control should be assessed by a physician, based on blood glucose results obtained by the patient.

When premixing is required, consistency of technique and careful blood glucose monitoring are especially important. Injection site Insulin may be injected into the subcutaneous tissue of the upper arm and the anterior and lateral aspects of the thigh, buttocks, and abdomen with the exception of a circle with a 2-inch radius around the navel.

Intramuscular injection is not recommended for routine injections. Rotation of the injection site is important to prevent lipohypertrophy or lipoatrophy. Rotating within one area is recommended e. This practice may decrease variability in absorption from day to day. Site selection should take into consideration the variable absorption between sites.

The abdomen has the fastest rate of absorption, followed by the arms, thighs, and buttocks. Exercise increases the rate of absorption from injection sites, probably by increasing blood flow to the skin and perhaps also by local actions.

Should You Fast? Most Muslims around the world fast during the holy season of Ramadan, as it is an essential part of their spiritual lives. Majority of people can do it without any problem; however, this is not true for those who live with diabetes. So, what do you need to consider when deciding if to fast, so as not to jeopardize your wellbeing or face any health problems?

Diabetes Type: If you have been diagnosed with Type 1 diabetes, it is especially important that you are aware that there are various risk factors associated with fasting; exacerbated by the fact that you are on insulin. Overall State of Health: It is safer for you to fast if you otherwise maintain healthy practices, and you practice good diabetes management.

If you eat well, exercise regularly, maintain a good blood glucose level, and do not experience any health complications, it should be fine. Do not put your health at risk by fasting. If you do not manage the condition well or have complications associated with diabetes, such as heart disease, kidney disease or visual problems, the risk of these issues becoming worse during the fast is high, and so you should consider not fasting.

Please note that each diabetes case is different, and so you should take preventive measures according to your needs. Tips to help you fast safely Fasting during Ramadan can be accomplished without causing harm to your health. If you have have no health complications and are in the clear with your health care team, please take note of the following health and lifestyle management tips: Carry your health care provider along Your healthcare team can also advise you on how to keep good diabetes control.

Ensure to discuss monitoring and how to handle emergencies should they arise, and have them suggest any Ramadan-specific changes in your diet, lifestyle, dose and timing of your medication or insulin regime. Monitor your blood glucose It is advisable that you do even more frequent glucose monitoring than usual when fasting until you get a sense of the safety of your revised insulin regimen.

The Diabetes and Ramadan International Alliance confirm that pricking the skin for blood glucose testing does not invalidate the fast. Good nutrition is particularly important at this time and maintaining a healthy eating plan will help you avoid the overeating of carbohydrates and fatty foods at the sunset meal. Include more slowly absorbed foods that have a lower glycaemic index, and try not to have too many sugary and fatty foods.

Also, have a plan for when to take your diabetes medicine, as well as how much, as discussed with your healthcare team.. Never skip the pre-dawn meal The suhoor meal, which is eaten shortly before dawn, is too essential for you to skip; it should be the largest meal of the day to give you sustained energy.

This meal is advised to be high in strong fiber, whole grain and complex carbohydrates such as oats, sourdough breads, couscous and brown rice because they are digested more slowly than other types of starchy meals. To have a balanced diet, meals high in strong fiber are to be paired with foods high in protein lean meat, poultry, fish, eggs, dairy products, seeds, nuts, beans, legumes and tofu and balanced with a combination of fruits and vegetables.

Food supplements are also welcome. Stay hydrated Make sure you drink plenty of fluids — try to drink two cups of sugar-free and decaffeinated fluids every hour to remain hydrated, with a target of at least 2L between sundown and sunrise.

Also, choose fluid-rich foods vegetables, such as cucumbers, green peppers and tomatoes, and fruits such as watermelon and strawberries to make sure you are well hydrated for the day.

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Glycemic index is a system that ranks foods on a scale from 1 to based on the impact they have on your blood glucose levels. Foods that are low in glycemic index are the ones you want to have making up a significant portion of your diet. Other non-starchy veggies include produce like spinach, kale, squash, or fruit.

Limit your intake of things like potatoes, meat, and dairy products. And of course, eliminate high glycemic index foods like white breads, white rice, and soda. Applebee's offers a lot of meals that have a high glycemic index in its assortment of burgers and appetizers. Indulge in some lobster and put your mind at ease, because the carb and sugar content are both very low. The sodium content is a bit high, like most dishes on this list, because restaurants alike are notorious for sprinkling too much salt into their meals.

Um, who isn't? And we bet Denny's wasn't the first place that came to your mind when you thought, healthy. Well think again, because this meal is balanced between all three macronutrients: Carbohydrates, fat, and protein. This meal is also diabetic-friendly, because with it doesn't exceed 60 grams of carbs. This is the perfect amount of carbohydrates for a person with diabetes to consume in one sitting.

Chang's Buddha's Feast Steamed Nutrition: calories, 4 g fat 0 g saturated fat , mg sodium, 32 g carbs 9 g fiber, 11 g sugar , 26 g protein If you're diabetic and vegetarian or vegan, this dish tailors to all of your dietary needs! Low sodium, a decent amount of carbs, and a spot-on protein content makes P.

Chang's Buddha Feast a feast worthy for all. Cheesecake Factory also has a SkinnyLicious menu that's worth a gander. But for a dish off of the regular menu, it's relatively low in carbs. Especially for a place that's renowned for carb-heavy cheesecake.

The sodium content is a bit high, but it's not everyday you get to eat out so moderation is key. If you're looking to whip up a killer salad at home, check out 30 Salad Recipes for Weight Loss. It has zero carbs and sugar, which means you'll have to eat an adequate amount of healthy carbs before or along with this meal. Ask for an order of steamed veggies to prevent hypoglycemia and for some additional nutrition.

The protein content is just a little high for those with diabetes but nothing that's overly concerning. Just make sure to limit your protein intake for the remainder of the day, or prior to ordering this omega 3-packed fish. There's a microvascular complication called nephropathy that occurs when a person with diabetes has been consuming too much protein.

Nephropathy is a fancy medical term that means kidney damage or kidney disease. This condition does not happen overnight, but it's good to be mindful that over time, stressing the kidneys with high levels of protein can cause kidney failure. This dish has a lot of protein, so make sure this is the only meat-containing meal of the day!

This meal is incredibly low in carbs— only 8 grams to be exact. So definitely don't shy away from that additional side of corn, which only adds calories, 21 grams carbs, and 9 grams sugar. Again, though, be mindful of that protein content. Protip: Consume 0. So if you're lbs. However, everyone's body is different so plus or minus a few grams of protein and you shouldn't have to worry. A meal plan is your guide for when, what, and how much to eat to get the nutrition you need while keeping your blood sugar levels in your target range.

A good meal plan will also: Include more nonstarchy vegetables, such as broccoli, spinach, and green beans. Include fewer added sugars and refined grains, such as white bread, rice, and pasta with less than 2 grams of fiber per serving. Focus on whole foods instead of highly processed foods as much as possible. Carbohydrates in the food you eat raise your blood sugar levels. How fast carbs raise your blood sugar depends on what the food is and what you eat with it. For example, drinking fruit juice raises blood sugar faster than eating whole fruit.

Eating carbs with foods that have protein, fat, or fiber slows down how quickly your blood sugar rises. For more information, see Carb Counting. Eating about the same amount of carbs at each meal can be helpful. Counting carbs and using the plate method are two common tools that can make planning meals easier too. Counting Carbs Keeping track of how many carbs you eat and setting a limit for each meal can help keep your blood sugar levels in your target range.

Work with your doctor or a registered dietitian to find out how many carbs you can eat each day and at each meal, and then refer to this list of common foods that contain carbs and serving sizes. The plate method is a simple, visual way to make sure you get enough nonstarchy vegetables and lean protein while limiting the amount of higher-carb foods you eat that have the highest impact on your blood sugar.

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