Type 2 Diabetes Adult Outpatient Insulin Guidelines - CMA Foundation

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Notes: • Patients on multiple daily doses of insulin should generally check at least 3-4 times per day. • Patients who are not on insulin may consider choosing an occasional meal and check both before and 1-2 hours after that meal, to see how the content of the meal affects the glucose levels. Recommend immediate checking of blood sugar levels using a personal meter if the patient thinks their blood sugar is low or they experience any of the following signs: • Weakness • Fatigue • Dizziness or shakiness • Excessive sweating • Fast heart rate • Headache • Hunger • Nervousness or irritability • Blurred vision Common patient barriers to using personal blood glucose meters and routine monitoring include: • Test strips can be expensive. Some insurance providers limit the number of strips patients can purchase each month. • Need to have testing supplies on hand. • Testing can be inconvenient and interrupt daily activities. • Fingersticks can cause pain and discomfort. (Many meters can be used painlessly in alternate sites. Patients should check their glucometer instruction manual.) • Monitoring is a constant reminder of the diagnosis. • Fear that elevated results mean their diabetes is worse or insulin is needed. • Belief that results place judgment on self-management efforts. 24 <strong>CMA</strong> FoundAtion . diAbetes And CArdiovAsCulAr diseAse Provider reFerenCe guide . july 2011
Proper Disposal of Syringes and Needles On September 1, 2008 a new California law went into effect prohibiting the disposal of home generated sharps waste in California residents’ trash or recycling containers and requiring that all such waste be transported to a collection center in an approved sharps container. This includes needles, pen needles, intravenous needles, lancets and other devices that are used to penetrate the skin for medication administration. 27 Table 16: Household Sharps Waste Disposal Options TAbLe 16 Household Sharps Waste Disposal Options Pharmacies Hospitals Local Household Hazardous Waste Programs Mail-Back Service You can also look for this information here Local jurisdictions’ sharps collection programs Collection programs Some drug stores take back their customers’ needles, especially in small quantities Hospitals may take back sharps from patients using regular outpatient services Call your local household hazardous waste agency and ask if they collect needles (sharps) at their collection facilities or on household hazardous waste days A list of sharps waste mail-back services authorized for use in California is available from the California Department Of Public Health (CDPH) at http://www.cdph.ca.gov/certlic/medicalwaste/Pages/MailBackSharps.aspx Your local white pages’ government section may list your city’s or county’s household hazardous waste department Visit the Earth 911.org at http://earth911.com/website or call 1-800- CLEANUP (1-800-253-2687), a service of Earth 911 Visit the Local Enforcement Agency Directory at http://www.calrecycle.ca.gov/LEA/Directory/default.asp Sharps and Medication Disposal Directory at http://www.calrecycle.ca.gov/HomeHazWaste/HealthCare/Collection Local Jurisdiction Sharps Collection Programs at http://www.calrecycle.ca.gov/HomeHazWaste/Sharps/LocatorProgrm.pdf This spreadsheet could help jurisdictions that don’t currently have collection programs to set up their own sharps collection program Needle Destruction Devices. The U.S. Food and Drug Administration (FDA) currently only lists the “Disintegrator” as a needle destruction device approved for use by self-injectors. Sharps Containers. The California Department of Public Health Medical Waste Management Program is recommending the use of sharps containers approved by the FDA. After accessing the FDA website, type “sharps” in the search box. The container names will display alphabetically. Listserv: To receive periodic information about sharps, subscribe to the Sharps and Medication Disposal Listserv. Contact: Please contact pharmasharps@calrecycle.ca.gov for questions or more information. <strong>CMA</strong> FoundAtion . diAbetes And CArdiovAsCulAr diseAse Provider reFerenCe guide . july 2011 25 Comprehensive management of type 2 diabetes
Page 1 and 2: 3 Comprehensive Management of Type
Page 3 and 4: TAbLe 13 Diabetes Care Guidelines/F
Page 5: TAbLe 15 Recommended blood Glucose
Page 9 and 10: TAbLe 17 Oral Medications Drug clas
Page 11 and 12: TABLe 18 Non-Insulin Injectables Dr
Page 13 and 14: Diabetes Coalition of California Ty
Page 15 and 16: CMA FoundAtion . diAbetes And CArdi
Page 17 and 18: TABLe 20 Insulin Injectables Drug c
Page 19 and 20: separate prescriptions or in fixed-
Page 21 and 22: TABLe 22 Oral Blood Pressure Loweri
Page 23 and 24: TABLe 22 Oral Blood Pressure Loweri
Page 25 and 26: Reference Card From the Seventh Rep
Page 27 and 28: Clinical Management of Dyslipidemia
Page 29 and 30: Pharmacotherapy for Dyslipidemia 23
Page 31 and 32: TABLe 24 Lipid combinations Fibric
Page 33 and 34: 4 Step 4 5 Step 5 6 Step 6 If 2+ ri
Page 35 and 36: 8 Step 8 Identify metabolic syndrom
Page 37 and 38: Hard Coronary Heart Disease (10-Yea
Page 39 and 40: Weight Loss/Maintenance Even a mode

Type 2 Diabetes Adult Outpatient Insulin Guidelines - CMA Foundation

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