By William T. Cefalu & Jack L. Leahy
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Extra info for Insulin Therapy
Sample text
GOALS OF NUTRITION THERAPY Nutrition goals for the insulin-treated diabetic patient are based on 1) the behavior changes that the individual with diabetes is willing and able to make and 2) the type of insulin program the patient is following. Goals are based on a patient's blood glucose, HbA I " serum lipid, blood pressure, and body weight goals. The type of insulin program is also an important consideration in the development of nutrition goals and the initiation of an individualized meal plan.
Insulin doesn't sting (glargine occasionally causes minor local reactions because of its acidic buffer), but using of alcohol for skin cleansing can sting and is not necessary. Also, injection-assistance devices may help in extreme cases (discussed later). There may be concerns that insulin therapy is the treatment of last resort, and is permanent. Patients may view themselves as failures or struggle to accept that they cannot avoid insulin or diabetes self-care any longer. Patients may have memories of family members or friends who suffered complications or death that they associate with having started insulin.
Place the tip of the lancet on the side of the finger opposite the nail bed with firm pressure, and release the button. Because the sides of the fingers have fewer nerve endings than the tips, they are less sensitive. Meters that allow for alternative test sites, most commonly the forearm, have recently become available. However, some patients find it difficult to obtain an adequate sample at the alternative sites. It is advisable to have patients demonstrate their technique before prescribing any meter, especially when alternative sites are to be used.