10 tips to strive with diabetes

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The DOC , Type 2 and Me

Written by Gary Stem

I am long-term Type 2 diabetic, diagnosed in the mid-1990’s. I’m like a lot of T2’s in that I do not remember the date or even the year. I progressed through all the available treatments of the day until one day my doctor said it, “Gary I believe it is time for you to start insulin treatment.” I knew it was coming, I had been threatened with it and had resisted it for years. I walked out of the office that day with a Levemir prescription; it was that day that I found the diabetic online community in the form of TuDiabetes.

Today I am an insulin pumping Type 2 diabetic. How I got to this point has been shaped by my participation at TuDiabetes. The knowledge I gained helped to guide my way; I soon learned that basal insulin alone would not be enough, soon MDI was prescribed and finally a pump, I have been pumping now for six years.

How my diabetes looks can best be summed up by something, a Type 1 friend said to me. She said, “Gary, Your diabetes looks almost exactly like mine.” I hadn’t realized it until then, but she was right. I do all the things a Type 1 does. I count carbs and calculate boluses, I monitor my blood sugar, and I do corrections when needed. I experience highs and lows. I do basal testing, and I have defined carb ratios and correction factors. I do pretty much everything any other insulin-dependent person does.

The diabetic online community, TuDiabetes, has been my information source and my lifeline, I was not taught all I needed to know by the medical community, I learned it from the members of TuDiabetes, I sometimes feel that they saved me. I learned more from them than about basals and boluses, more than low carb dieting and exercising, I learned that others out there cared about me. They encouraged me, and they consoled me. I learned it is more than the diabetic online community; it is a diabetic online family.

I realized in the earliest part of my involvement in this diabetic online family that I wanted to give back to it. I did everything I could think of to provide support. Eventually, I was asked to be part of the TuDiabetes Administrative Team, I have served on this team for six years now, it is my way of giving back to the community.

For all TuDiabetes has done for me the significant thing about it is not how it has helped me. I am reminded of the importance of TuDiabetes each time I hear a new member or even a not so new member says this or something similar, “I am so glad I have found this community of people like me, I no longer feel alone.” I smile each time I hear this said; it confirms our purpose.

TuDiabetes exist so that no person touch by diabetes should feel alone. I think that is true for the entire DOC. I am proud to be a part of it.


Connect with Gary and many others in our Forum. Join the conversations!

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Healthy Coping & Mental Health

 

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Reducing Diabetes Complications

 

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Healthy Living

Browse through our educational resources, the more you know about your diabetes the better outcomes in your management. 


 

 

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General Diabetes Information


Daily Living

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7 Helpful Tips for Checking Your Blood Sugar and Caring for Your Meter

Most meters come with three parts:

  • Lancet – A needle that is used to get a drop of blood from your finger or another part of your body.
  • Test Strip – The strip where you put the blood you are checking.
  • Control Solutions – Liquid used to make sure your meter is working properly.

Meters come in different sizes. Meters also come with different features. Some meters let you track and print out your results, you can upload them to a cloud service or they can get transferred to your smartphone via bluetooth. Others have audio and larger screens to help people who have problems seeing. The meter you choose should fit your lifestyle and your needs. We are now seeing more and more meters providng the option of report creation and data analysis, this is extremely helpful to identify patterns and make the needed changes.


7 Helpful Tips for Checking Your Blood Sugar and Caring for Your Meter

  • Read the directions for the meter and the test strips before you start using them.
  • Wash your hands before you check your blood sugar. Food, juice or dirt on your fingers may affect your blood sugar result.
  • Use the right strip for your meter and callibration code if needed. The meter may give you the wrong results if you use the wrong test strip or wrong callibration code.
  • Write down your results and the date and time you checked. Do this even if your meter tracks your numbers. Take the results with you when you go to your doctor.
  • Clean your meter as directed. Glass cleaners, ammonia and other cleaning products may damage your meter.
  • Talk to your health care provider about how your medicines will affect your blood sugar. Other medications can affect your blood sugar reading.
  • Take your meter with you when you go to your doctor. This way you can check your blood sugar in front of the doctor or nurse to make sure you are doing it the right way. Your health care provider may be able to print out your blood sugar results from your meter.

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Insulin, Medicines, & Other Diabetes Treatment

Taking insulin or other diabetes medicines is often part of treating diabetes. Along with healthy food choices and physical activity, medicine can help you manage the disease. Some other treatment options are also available.

What medicines might I take for diabetes?

The medicine you take will vary by your type of diabetes and how well the medicine controls your blood glucose levels, also called blood sugar. Other factors, such as your other health conditions, medication costs, and your daily schedule may play a role in what diabetes medicine you take.

Type 1 diabetes

If you have type 1 diabetes, you must take insulin because your body no longer makes this hormone. You will need to take insulin several times during the day, including with meals. You also could use an insulin pump, which gives you small, steady doses throughout the day.

Type 2 diabetes

Some people with type 2 diabetes can manage their disease by making healthy food choices and being more physically active. Many people with type 2 diabetes need diabetes medicines as well. These medicines may include diabetes pills or medicines you inject under your skin, such as insulin. In time, you may need more than one diabetes medicine to control your blood glucose. Even if you do not take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital.

Gestational diabetes

If you have gestational diabetes, you should first try to control your blood glucose level by making healthy food choices and getting regular physical activity. If you can’t reach your blood glucose target, your health care team will talk with you about diabetes medicines, such as insulin or the diabetes pill metformin, that may be safe for you to take during pregnancy. Your healthcare team may start you on diabetes medicines right away if your blood glucose is very high.

No matter what type of diabetes you have, taking diabetes medicines every day can feel like a burden sometimes. You may also need medicines for other health problems, such as high blood pressure or high cholesterol, as part of your diabetes care plan. View resources that may help you manage your medication plan.

What are the different types of insulin?

Several types of insulin are available. Each type starts to work at a different speed, known as “onset,” and its effects last a different length of time, known as “duration.” Most types of insulin reach a peak, which is when they have the strongest effect. Then the effects of the insulin wear off over the next few hours or so.

What are the different ways to take insulin?

The way you take insulin may depend on your lifestyle, insurance plan, and preferences. You may decide that needles are not for you and prefer a different method. Talk with your doctor about the options and which is best for you. Most people with diabetes use a needle and syringe, pen, or insulin pump. Inhalers, injection ports, and jet injectors are less common.

Needle and syringe

You’ll give yourself insulin shots using a needle and syringe. You will draw up your dose of insulin from the vial, or bottle, into the syringe. Insulin works fastest when you inject it in your belly, but you should rotate spots where you inject insulin. Other injection spots include your thigh, buttocks, or upper arm. Some people with diabetes who take insulin need two to four shots a day to reach their blood glucose targets. Others can take a single shot.

Photo of an insulin vial and a syringe.
Insulin shots involve drawing insulin from a vial into a syringe and then injecting it under your skin.

Pen

An insulin pen looks like a pen but has a needle for its point. Some insulin pens come filled with insulin and are disposable. Others have room for an insulin cartridge that you insert and then replace after use. Insulin pens cost more than needles and syringes but many people find them easier to use.

Photo of an insulin pen
An insulin pen is a convenient way to take insulin

Pump

An insulin pump is a small machine that gives you small, steady doses of insulin throughout the day. You wear one type of pump outside your body on a belt or in a pocket or pouch. The insulin pump connects to a small plastic tube and a very small needle. You insert the needle under your skin and it stays in place for several days. Insulin then pumps from the machine through the tube into your body 24 hours a day. You also can give yourself doses of insulin through the pump at mealtimes. Another type of pump has no tubes and attaches directly to your skin, such as a self-adhesive pod.

Photo of a woman holding an insulin pump with the tube connected to a patch on her stomach, where the needle is inserted.
Insulin pumps deliver insulin 24 hours a day.

Inhaler

Another way to take insulin is by breathing powdered insulin from an inhaler device into your mouth. The insulin goes into your lungs and moves quickly into your blood. Inhaled insulin is only for adults with type 1 or type 2 diabetes.

Injection port

An injection port has a short tube that you insert into the tissue beneath your skin. On the skin’s surface, an adhesive patch or dressing holds the port in place. You inject insulin through the port with a needle and syringe or an insulin pen. The port stays in place for a few days, and then you replace the port. With an injection port, you no longer puncture your skin for each shot—only when you apply a new port.

Jet injector

This device sends a fine spray of insulin into the skin at high pressure instead of using a needle to deliver the insulin.

What oral medicines treat type 2 diabetes?

You may need medicines along with healthy eating and physical activity habits to manage your type 2 diabetes. You can take many diabetes medicines by mouth. These medicines are called oral medicines.

Most people with type 2 diabetes start medical treatment with metformin pills. Metformin also comes as a liquid. Metformin lowers the amount of glucose that your liver makes and helps your body use insulin better. This drug may help you lose a small amount of weight.

Other oral medicines act in different ways to lower blood glucose levels. You may need to add another diabetes medicine after a while or use a combination treatment. Combining two or three kinds of diabetes medicines can lower blood glucose levels more than taking just one.

Read about different kinds of diabetes medicines from the Food and Drug Administration (FDA).

What other injectable medicines treat type 2 diabetes?

Besides insulin, other types of injected medicines are available. These medicines help keep your blood glucose level from going too high after you eat. They may make you feel less hungry and help you lose some weight. Other injectable medicines are not substitutes for insulin. Learn more about noninsulin injectable medicines.

What should I know about side effects of diabetes medicines?

Side effects are problems that result from a medicine. Some diabetes medicines can cause hypoglycemia, also called low blood glucose, if you don’t balance your medicines with food and activity.

Ask your doctor whether your diabetes medications can cause hypoglycemia or other side effects, such as upset stomach and weight gain. Take your diabetes medicines as your health care professional has instructed you, to help prevent side effects and diabetes problems.

Do I have other treatment options for my diabetes?

When medicines and lifestyle changes are not enough to manage your diabetes, a less common treatment may be an option. Other treatments include bariatric surgery for certain people with type 1 or type 2 diabetes, and an “artificial pancreas” and pancreatic islet transplantation for some people with type 1 diabetes.

Bariatric surgery

Also called weight-loss surgery or metabolic surgery, bariatric surgery may help some people with obesity and type 2 diabetes lose a large amount of weight and regain normal blood glucose levels. Some people with diabetes may no longer need their diabetes medicine after bariatric surgery. Whether and for how long blood glucose levels improve seems to vary by the patient, type of weight-loss surgery, and amount of weight the person loses. Other factors include how long someone has had diabetes and whether or not the person uses insulin.1

Recent research suggests that weight-loss surgery also may help improve blood glucose control in people with type 1 diabetes who are obese.2

Researchers are studying the long-term results of bariatric surgery in people with type 1 and type 2 diabetes.

Artificial Pancreas

The NIDDK has played an important role in developing “artificial pancreas” technology. An artificial pancreas replaces manual blood glucose testing and the use of insulin shots or a pump. A single system monitors blood glucose levels around the clock and provides insulin or a combination of insulin and a second hormone, glucagon, automatically. The system can also be monitored remotely, for example by parents or medical staff.

In 2016, the FDA approved a type of artificial pancreas system called a hybrid closed-loop system. This system tests your glucose level every 5 minutes throughout the day and night, and automatically gives you the right amount of insulin.

You still need to manually adjust the amount of insulin the pump delivers at mealtimes. But, the artificial pancreas may free you from some of the daily tasks needed to keep your blood glucose stable—or help you sleep through the night without the need to wake and test your glucose or take medicine.

The hybrid closed-loop system is expected to be available in the U.S. in 2017. Talk with your healthcare provider about whether this system might be right for you.

The NIDDK has funded several important studies on different types of artificial pancreas devices to better help people with type 1 diabetes manage their disease. The devices may also help people with type 2 diabetes and gestational diabetes.

Pancreatic islet transplantation

Pancreatic islet transplantation is an experimental treatment for poorly controlled type 1 diabetes. Pancreatic islets are clusters of cells in the pancreas that make the hormone insulin. In type 1 diabetes, the body’s immune system attacks these cells. A pancreatic islet transplant replaces destroyed islets with new ones that make and release insulin. This procedure takes islets from the pancreas of an organ donor and transfers them to a person with type 1 diabetes. Because researchers are still studying pancreatic islet transplantation, the procedure is only available to people enrolled in research studies. Learn more about islet transplantation studies.

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Healthy aging with diabetes

As older adults live longer, they may have more than one chronic disease.  Or, they may have a health problem that can lead to another condition or injury if not properly managed.   The older adult may also experience healthcare in various settings, such as the hospital, assisted living facility, or at home. These situations can affect the health and function of the older adult and therefore require careful management to ensure proper care and improve or maintain the quality of life.

Diabetes and Other Conditions

Having high levels of glucose (sugar) in your bloodstream puts you at risk for a variety of other health issues. That can make diabetes an especially challenging disease for older adults to manage. Having diabetes increases the chances of having heart attacks, strokes, or kidney or eye problems. And if you have diabetes, it is likely that you may be treated for other health problems, such as high blood pressure, high cholesterol, or arthritis.

When you know what to expect, you can often prevent or limit the impact these problems can have on your life. Your healthcare provider will probably ask you about these conditions, or order tests to see if you have any of their signs. Don’t hesitate to discuss any symptoms you may experience, even if they seem minor to you.

Medication Interactions

If you have diabetes, it is likely that your healthcare provider is also treating you for other problems.  That means you could be taking several different medications, which can put you at risk for medication interactions.

Here’s how to steer clear of problems:

  • Make a list of all your medications and their dosages. Make sure you include any vitamins, herbs, over-the-counter medicines, or other dietary supplements you take. It is important that you keep this with you at all times, especially in the case of a medical emergency.
  • When you visit your healthcare provider, bring your actual medications with you. This way they can be sure the directions on the bottles are up-to-date.
  • Make sure you know why you are taking each medicine, how and when to take it, and what the common side effects are.
  • If possible, have all your prescriptions filled at the same pharmacy. This way, your pharmacist can alert you if the medications you are prescribed could interact with each other.
  • Read the information that comes with your medications. Ask your healthcare provider or pharmacist if you have questions.

Depression

For reasons we don’t fully understand, older adults who have diabetes are at risk for depression. In fact, as many as a third of all people with diabetes may experience depression. Yet, only 25 to 50 percent of diabetic patients are formally diagnosed with depression. You might not take depression seriously. You may think that it’s “just the blues,” or that it’s not important enough to discuss with your healthcare provider. But depression can interfere with your ability to enjoy life, as well as your ability to watch and control your diabetes. So it is important to recognize the signs of depression and treat it as you would any illness. It is normal to feel grief after a loss, or have occasional days of “feeling blue.” But when you feel sad or hopeless for more than a couple of weeks, it’s time to get help.

There are specific signs of depression to look out for. These include having trouble sleeping, concentrating, or remembering, feeling more tired than usual, having sudden weight gain or loss, or losing pleasure in doing things you usually enjoy. If you are experiencing any of these symptoms, talk with your healthcare provider. Treatment can help you feel better pretty quickly. The earlier depression is treated, the better.

Memory Loss

Problems with memory and brain function can be more common in older people with diabetes. Your healthcare provider may do some tests to check for memory loss. Be sure to let your provider know if you experience memory problems, if others have told you they’re concerned about your memory, or if you’re having trouble managing any of your daily activities (for example, balancing your checkbook or taking your medications).

Urinary Incontinence (Loss of Bladder Control)

Older women with diabetes are at increased risk for urinary incontinence, which is a common condition among older women. In fact, nearly 70% of all women experience problems from time to time, so there’s no need to feel embarrassed if it happens to you. The good news is that there are simple approaches to manage incontinence. Your healthcare provider can help find a treatment that works for you. Be sure to discuss any bladder control problems you experience so you can get the help you need.

Falls

Many factors put older adults with diabetes at greater risk of falling. These include medication side effects, loss of feeling in the legs or feet, low blood sugar, or poor vision. Home factors such as poor lighting and clutter can also contribute to falls. Be sure to let your healthcare provider know if you’ve had a fall.

Chronic Pain

Diabetes can lead to pain caused by poor circulation or nerve damage. This can be a very difficult by-product of diabetes to deal with. Therefore, it’s very important to tell your healthcare provider about any pain you may be feeling, especially if it gets in the way of your daily activities or quality of life. Never let the pain go untreated. And don’t feel like you’re complaining or bothering your healthcare provider when you bring it up.


Source: HealthyAging.org

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Family Health History Quiz

Family health history is an important risk factor for developing a number of serious diseases, including type 2 diabetes. In fact, most people with type 2 diabetes have a family member – such as a mother, father, brother, or sister – with the disease.

We encourage you to take advantage of family gatherings to share information about their health history – especially when it comes to diabetes.

Knowing your family health history is important because it gives you and your health care team information about your risk for type 2 diabetes and other health problems.

Four Questions You Should Ask Your Family About Diabetes & Family Health History

Knowing your family health history is important. Here are some questions to help you learn more about your family history of diabetes.

  • Does anyone in the family have type 2 diabetes? Who has type 2 diabetes?
  • Has anyone in the family been told they might get diabetes?
  • Has anyone in the family been told they need to lower their weight or increase their physical activity to prevent type 2 diabetes?
  • Did your mother get diabetes when she was pregnant? This is also known as gestational diabetes (GDM).

If the answer to any of these is yes, or you have a mother, father, brother, or sister with type 2 diabetes, you may be at an increased risk for developing type 2 diabetes.

True or false? If my parent or sibling has type 2 diabetes, I am at an increased risk to develop type 2 diabetes.

True – A family history of type 2 diabetes is a strong risk factor for the disease. If you have a mother, father, brother, or sister with diabetes, you are at risk for type 2 diabetes. But even if you have a family history of type 2 diabetes, there are many things you can do to lower your risk. If you’re overweight, losing five to seven percent of your body weight (for example, 10 pounds if you weigh 200 pounds) by exercising 30 minutes a day, five days a week and making healthy food choices can help to prevent or delay type 2 diabetes.

True or false? My mother has been told by her health care team that she is at high risk for diabetes, or that she has prediabetes, so she will get diabetes very soon.

False – Studies have shown that people at high risk for diabetes or with prediabetes can turn back the clock to delay or even prevent a diagnosis of diabetes by losing five to seven percent of your body weight if overweight (for example, 10 pounds if you weigh 200 pounds). You and your family can lose a modest amount of weight through simple lifestyle changes, such as increasing physical activity to about 30 minutes a day, five days a week and make healthy food choices. For some people with prediabetes, intervening early can actually return elevated blood glucose levels to the normal range.

True or false? Type 2 diabetes runs in my family, so there is nothing I can do to prevent getting the disease.

False – Even though a family history of type 2 diabetes is a strong risk factor for developing the disease, some of this risk is a result of lifestyle. Being overweight, making unhealthy food choices, and not getting enough exercise can increase your risk for type 2 diabetes. If you are overweight, losing five to seven percent of your body weight (for example, 10 pounds if you weigh 200 pounds) by making healthy food choices and increasing physical activity to about 30 minutes a day, five days a week can help lower your risk for type 2 diabetes. Adopting healthy habits as an individual or as a family is good for everyone.

True or false? My mother was diagnosed with diabetes when she was pregnant with me so she and I are both at an increased risk of developing diabetes.

True – When a woman gets diabetes during pregnancy, called gestational diabetes, she is at an increased risk of developing diabetes for the rest of her life. Additionally, her child is at an increased risk of becoming obese and for developing type 2 diabetes for the rest of his or her life. But there are many ways to lower this risk for both mother and child.

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Forum Guidelines

What is our mission?

Our mission is to connect people touched by diabetes (individuals who live with type 1, type 2 and other types of diabetes, as well as their loved ones)

We want to provide:

  • Empathy- A positive environment where our members support and help each other. This doesn’t mean it’s all roses all the time, but it means that, overall, we strive for maintaining an encouraging and supportive space for all people touched by diabetes.
  • Support, regardless your diabetes type-  We promote active and proactive actions to stay healthy while living with diabetes.
  • Valuable information- We encourage the exchange of information and storytelling about diabetes. We believe the community as a whole will have access to far more information and resource than any particular individual and we want to learn about it.
  • Respect- We value diverse points of view. All people touched by diabetes are welcome. You may find opinions and positions that are not similar to yours, and it’s OK to disagree. It’s just not OK to do so in a disrespectful manner. If you are unsure about whether something may be disrespectful to others, try to put yourself in the shoes of the other person and consider how you would feel if you were on the receiving end of the comments/contribution you are making.
  • Patience and Tolerance-  We embrace openness and authenticity, as long as it doesn’t conflict with the other values. If you disagree with someone else’s comment, in reply to something you contributed to the community, as long as it was a comment that was made in alignment with these values, don’t delete it. Doing so shows no respect for the other person’s comment.

We want to keep our community FREE of:

  • Judgmental tones.
  • Promotional asks for members contact information to sell products, websites, fundraisers, or seminars.
  • Spam- unsolicited or repetitive messages.
  • Sales ads or the intention to distribute ANY product.
  • SALES, GIVEAWAYS or EXCHANGES of prescription items.
  • Asks to sign petitions of any kind.
  • Medical advice or prescribing to modify treatment.
  • Research without prior authorization.
  • Proselytizing.
  • Offensive language.
  • Libelous or defamatory postings.
  • Posts containing hate, misogynistic, sexist, or racist content.
  • Pictures, or text containing expressions of abuse, hate, offensive conduct, obscenity, pornography, sexually explicit or material that could be used to raise civil or criminal liability under applicable law or regulations or may be in conflict with these Terms of Services of the community.
  • Hostile or disrespectful content towards any member of the community, including moderators and staff.  
  • Postings unrelated to the original topic (“off-topic”)
  • Solicitation.
  • More than one profile on TuDiabetes or any impersonation, in any mode of communication.
  • Topics or posts which are disruptive, harmful or damaging to the “community” (as opposed to another member)
  • Malicious gossip and trolling for dates are not tolerated on TuDiabetes.
  • Political debates.

NOTE: The minimum age to have a profile in the community is 13 or over! All underage accounts will be deleted.


Last update: 2/26/2018

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Glucagon

Why is this medication prescribed?

Glucagon is a hormone produced by the pancreas. Glucagon is used to raise very low blood sugar. Glucagon is also used in diagnostic testing of the stomach and other digestive organs.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Glucagon is usually given by injection beneath the skin, in the muscle, or in the vein. It comes as a powder and liquid that will need to be mixed just before administering the dose. Instructions for mixing and giving the injection are in the package. Glucagon should be administered as soon as possible after discovering that the patient is unconscious from low blood sugar. After the injection, the patient should be turned onto the side to prevent choking if they vomit. Once the glucagon has been given, contact your doctor. It is very important that all patients have a household member who knows the symptoms of low blood sugar and how to administer glucagon.

If you have low blood sugar often, keep a glucagon kit with you at all times. You should be able to recognize some of the signs and symptoms of low blood sugar (i.e., shakiness, dizziness or lightheadedness, sweating, confusion, nervousness or irritability, sudden changes in behavior or mood, headache, numbness or tingling around the mouth, weakness, pale skin, sudden hunger, clumsy or jerky movements). Try to eat or drink a food or beverage with sugar in it, such as hard candy or fruit juice, before it is necessary to administer glucagon.

Follow the directions on your prescription label carefully, and ask your pharmacist or doctor to explain any part you or your household members do not understand. Use glucagon exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

What special precautions should I follow?

Before using glucagon,

•tell your doctor and pharmacist if you are allergic to glucagon, any other drugs, or beef or pork products.

•tell your doctor and pharmacist what prescription and nonprescription medications you are taking, including vitamins.

•tell your doctor if you have ever had adrenal gland problems, blood vessel disease, malnutrition, pancreatic tumors, insulinoma, or pheochromocytoma.

•tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.

What side effects can this medication cause?

Glucagon may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

•nausea

•vomiting

•rash

•itching

Brand names

•GlucaGen® Diagnostic Kit

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