We are pleased to welcome you to our practice. Please take a few minutes to fill out this form as completely as you can. If you have questions we’ll be glad to help you. We look forward to working with you in maintaining your dental health. Date __________________________ Phone (_____) _________________________ Alt. Phone (_____) _______________________________Name __________________________
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M5045 lantus_cmefacgde_padM5045 Lantus_CMEFacGde_Pad 9/27/06 1:40 PM Page 1**Tony_Weir **MacHD: Tony Weir-Jobs:Current Jobs: M5045 Lantus: Starting insulin:
• It is important to monitor your blood sugars closely as you patient guide
• Record your blood sugars every day before breakfast and 2–3 other times every day; test before meals unless your • You and your doctor have decided that you will start • Record your blood sugars and any changes in activity or food in your diary and bring this to your appointment; this information helps your doctor understand your diabetes control • Try to take your insulin around the same time each day • You are trying to reach target blood sugars of 4 – 7 mmol/L • Insulin helps lower your fasting blood sugar level • Continue taking your other diabetes medications unless • If you think your blood sugar is low, check your level and your doctor has told you to change the dose or stop taking • If you have glucose levels < 4 mmol/L or symptoms of low blood sugar more than twice in one week, call your • Your target fasting blood sugar level Practical insulin tips
• Inject _____ units of insulin each day • Continue to increase by 1 unit every day until your blood sugar level is _____ mmol/L before • Do not increase your insulin when your fasting • Insulin is usually given at a 90° angle discarded in an approved Sharps container • Weight gain – it is important to see a dietitian and follow • Do not remove the cartridge of insulin from your pen until a healthy lifestyle including regular exercise it is empty; keep the pen with the cartridge in it at room Instructions for Your Oral Diabetes Medications • Store unopened insulin in the refrigerator • Do not use insulin past the expiry date • If you have any concerns about your blood sugar levels • If you have reached your target blood sugar level • If you have a blood sugar less than 4.0 mmol/L and/or symptoms of low blood sugar (hypoglycemia), such astrembling, sweating, anxiety, nervousness, irritability, a racing heart, or shaking more than twice a week • If you think you have taken too much insulin M5045 Lantus_CMEFacGde_Pad 9/27/06 1:40 PM Page 2**Tony_Weir **MacHD: Tony Weir-Jobs:Current Jobs: M5045 Lantus: • It is important that you measure your blood sugar if you are • Follow your meal plan amounts and timing of meals not feeling well, and that you continue to take your insulin • Call the clinic if your blood sugar levels are too high or low • Understand the relationship between exercise, medications, during times of illness or if you are not able to eat or drink Important
You should always test your blood sugar before operat- ing a motor vehicle. If your blood glucose is 4.0 mmol/L or less, you should treat your blood sugar and wait one hour before driving. Professional drivers should discuss their testing requirements with their healthcare providers.
Treatment of diabetes can occasionally lead to hypoglycemia (low blood sugar levels). For people who are on insulin ordrugs that cause insulin to be secreted in the body, the Canadian Diabetes Association (CDA) defines hypoglycemia • If not above 4.0 mmol/L, take another 15 grams of CHO as blood glucose < 4.0 mmol/L. The information below is • Treatment of low blood sugar should be followed with to help you understand hypoglycemia. If you are experiencing either a snack or a meal within 30 minutes symptoms of hypoglycemia, you should check your • 5 tablets of DEXTRO ENERGY or DEXTROSOL • 3 tsp. (15 mL) of sugar or 4 sugar cubes • Eating less than what is in your meal plan • 6 lifesavers, or 4 hard candies, or 14 skittles • 1 tbsp. (15 mL) of honey, syrup, jam or jelly Medications • Taking too much diabetes medication or insulin
• 3/4 cup (6 oz. or 175 mL) of fruit juice or regular soda pop Activity
• 1 – 1 1/4 cup (10 – 12 oz.) of milk • Not adjusting medication prior to activity • Not taking in extra carbohydrates prior to activity Important
Remember that chocolate is absorbed slowly because of the fat content and is not a good choice to treat low Early Signs • Nervousness
If you are on ACARBOSE or PRANDASE® you must use glucose or dextrose, or, if unavailable, milk or honey.
Always carry some fast-acting sugar with you.
Ensure that you have medical identification (MedicAlert) and a wallet card that discusses hypoglycemia and how Later Signs • Drunk-like behaviour • Changed behaviour
If two or more low blood sugars occur in one week, contact
your doctor or diabetes care team.
Veterinary PrODUCtS liSt Contacts : Tel +33 (0) 1 55 46 50 00 - Fax +33 (0) 1 47 39 91 email@example.com - firstname.lastname@example.org - email@example.com - firstname.lastname@example.orgThe availability of these products are under the local legislation. Patent position to be verified by the customer. 4-AMINO BENZOIC ACID CLOSANTEL SODIUM ACETIC ACID COBALT GLUCONATE ACETYLCY