Being Prepared for Severe Lows Just in Case

00:01 – 00:18 Speaker 1: Being prepared. There is a couple of things to talk about. So the initial treatment for any kind of low blood sugar is carbohydrates, and that can be glucose tabs, that can be juice that can be whatever. I find that most of my patients will find their thing that they like to have around, whether it’s Skittles or glucose tabs or whatever.

00:19 – 00:39 Speaker 1: And then you got to put that stuff everywhere. So my kind of go-to personally for low blood sugars is glucose tabs. And I like glucose tabs because I don’t like them. Meaning that I can have them everywhere and I’m never like, John’s in for a glucose tab and I’ll just go kind of like snack on them so that they’re for an emergency.

00:39 – 00:54 Speaker 1: But I don’t have any desire to kind of eat them otherwise. If I had gummy bears everywhere, I’d probably just start eating them and then I’d have no gummy bears. So I just go on Amazon and I buy a ton of these and I have them in my car, I have them in my work bag, I have them, you know, by my bed stand.

00:54 – 01:22 Speaker 1: I have them everywhere that I could potentially need them because the worst thing to happen is that you have a low blood sugar and you don’t have anything. So that’s kind of step one is the carbohydrates. And then step two is where your provider comes in is these glucagon rescue products. And it’s something that everybody who is on insulin or low blood sugar causing medications needs to have as a as a rescue device.

01:22 – 01:44 Speaker 1: So the idea with kind of glucagon products is that this is something that can be administered usually by somebody else–a friend or family member if you have a severe low blood sugar that you can’t treat yourself with carbohydrates. So I have, you know, several glucagon products that can kind of at home here at the office and advise every patient to do the same.

01:44 – 02:02 Speaker 1: So you have to ask your provider for it because to be honest, on the provider side, sometimes even I’ll forget to bring this up with patients. I put it in my kind of note template. So I try to remember to do it every time. I’m pretty good about it, but at some some kind of check box that every patient needs to check at each visit.

02:02 – 02:24 Speaker 1: Do I have, you know, a glucagon product? Is it a, you know, non-expired prescription do I know where it is? Do the people that might administer it know how to find it and use it is so critical because this is a life-saving device, therapy, whatever you want to call it. So it’s a critical kind of component of every person with diabetes.

02:25 – 02:53 Speaker 1: Diabetes kit, if you will. And you might go 20 years without ever having to use it (glucagon). But that day that you need it, you’re going to be really thankful that it’s there and it can be kind of again, it will be life saving. So it’s just a part of everybody who is on insulin certainly should have a glucagon rescue product, talk to their provider about it and it can get can be, you know, a pain to kind of like have this medication.

02:53 – 03:09 Speaker 1: You’re not you feel like you’re not using it, but it’s like having a parachute in something that you wouldn’t get on a plane or, you know, jump out of a plane without a parachute. Like you don’t want to be on these medications on insulin, especially without having glucagon around. It’s just it’s really that important.

03:10 – 03:25 Speaker 2: We do use glucagon rescue therapy. We ask patients and their relatives to check the expiry date because it doesn’t have an infinite life. And when it runs beyond that date or close to that date, they need to replace it.

03:26 – 03:51 Speaker 3: Living with diabetes is difficult because it affects every aspect of your lives, sort of from the moment you wake up and even when you’re sleeping it affects every choice that you’re going to make about what you’re going to put into your body. It affects how close you need to be to a bathroom if your blood sugar or the medications you take make you urinate, it makes you think about it when you’re traveling somewhere.

03:52 – 04:12 Speaker 3: Can I go on vacation? Will there be medical help there? What medications do I have to bring with me? Do they need to be stored at a particular temperature? And I think that’s that’s burdensome for people and difficult it’s not just sort of like, you know, something that comes in and out of your life at certain moments. I think it’s it’s really always there.

04:12 – 04:37 Speaker 3: And I think patients who have diabetes often feel that it’s burdensome to bring their loved ones and their coworkers and colleagues and friends into their action plans. They don’t want to do it. They want to manage it themselves. They don’t want to, you know, have to bother somebody. And, you know, as caregivers, I think it’s important for us to step up and say, no, I want to help.

04:37 – 04:50 Speaker 3: You’re important and I want to help you succeed. I want to be prepared for this. I think like those discussions between patients and caregivers and sort of that honesty is really important for us achieving great outcomes.

04:51 – 05:20 Speaker 4: I recommend they discuss severe low blood sugar events and practice appropriate responses with their caregivers and close friends. I suggest that patients talk with their caregivers and have some simulation for what would happen in the event of low blood sugar. I tell them that the first thing to do is to check if the patient can safely take sugar by mouth or not, and if he/she cannot do so, the person around him/her should call an ambulance immediately.

05:20 – 05:34 Speaker 4: I also tell them that they do not have to rush or panic when calling an ambulance. It is also important for caregivers to know in advance how to administer glucagon, although in Japan this glucagon administration is limited to family members.